Effectiveness of Bupivacaine Liposome Injectable Suspension for Postoperative Pain Control in Total Knee Arthroplasty: A Prospective, Randomized, Double Blind, Controlled study

• Published in: The Journal of arthroplasty Vol. 32; no. 9; pp. S268 - S271
• Main Authors: DeClaire, Jeffrey H., MD, Aiello, Paige M., MS, Warritay, Olayinka, MD, MPH, Freeman, D. Carl, Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2017
• Subjects: Aged; Amides - administration & dosage; Anesthetics, Local - administration & dosage; Arthroplasty, Replacement, Knee - adverse effects; Body Mass Index; Bupivacaine - administration & dosage; Double-Blind Method; Epinephrine - administration & dosage; Female; Humans; Injections, Intra-Articular - methods; Ketorolac - administration & dosage; Length of Stay; liposomal bupivacaine; Liposomes - administration & dosage; Male; Middle Aged; Morphine - administration & dosage; Narcotics - administration & dosage; Orthopedics; osteoarthritis; Pain Management; Pain Measurement; Pain, Postoperative - drug therapy; Postoperative Period; Prospective Studies; total knee arthroplasty; total knee replacement; Total Knee Replacement; Total Knee Arthroplasty; Osteoarthritis; Pain Management; total knee arthroplasty; liposomal bupivacaine; total knee replacement; pain management; Therapeutic TYPE I; osteoarthritis
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2017.03.062

Abstract Background We compared the effectiveness of liposomal bupivacaine to ropivacaine, each as part of multimodal pain management, in TKA postoperative pain control. Methods This prospective, double blind study randomized 96 TKA patients into a control group (periarticular injection of ropivacaine, ketorolac, morphine, and epinephrine in saline; 100cc) or an experimental group (periarticular injection of bupivacaine, ketorolac, morphine, and epinephrine in saline; 80cc plus 1.3% liposomal bupivacaine 20cc; total injection 100cc). The postoperative use of narcotics, Visual Analog Pain scores, hours to ambulate 100 feet, and length of hospital stay were recorded. Results There was no significant difference between the two groups (control N=49, experiment N=47) in mean narcotic use per hour, total narcotic use during hospital stay, time to ambulate 100 feet, length of hospital stay, or Visual Analog Score for pain post-operatively. Conclusion There is no benefit in the use of liposomal bupivacaine compared to ropivacaine for postoperative pain control in TKA.