Improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspension
Patients undergoing total knee arthroplasty (TKA) report low satisfaction with postoperative pain control. The purpose of this study is to examine if there is a difference in post-operative pain for TKA patients without femoral nerve block receiving an intra-operative pericapsular injection of bupiv...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2016-03-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344115000345 |
| _version_ | 1818839996968206336 |
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| author | Mark A. Snyder, MD Christina M. Scheuerman, BSN, RN Justin L. Gregg, MA Christopher J. Ruhnke, MD Kathryn Eten, BSN, RN |
| author_facet | Mark A. Snyder, MD Christina M. Scheuerman, BSN, RN Justin L. Gregg, MA Christopher J. Ruhnke, MD Kathryn Eten, BSN, RN |
| author_sort | Mark A. Snyder, MD |
| collection | DOAJ |
| description | Patients undergoing total knee arthroplasty (TKA) report low satisfaction with postoperative pain control. The purpose of this study is to examine if there is a difference in post-operative pain for TKA patients without femoral nerve block receiving an intra-operative pericapsular injection of bupivacaine liposome suspension (EXPAREL; Pacira Pharmaceuticals, Inc., San Diego, California) versus a concentrated multi drug cocktail. Seventy TKA patients were randomly assigned to either the bupivacaine liposome or the multi-drug cocktail. Post-operative pain scores, morphine sulfate equivalence consumption values, adverse events, and overall pain control satisfaction scores were collected. Patients reported significantly higher pain level for the cocktail group on post-op day 1 (p < .05) and post-op day 2 (p < .01) versus the bupivacaine liposome group. This same trend was found for morphine sulfate equivalence consumption in the PACU (p < .01) and post-op day 2 (p < .01). Higher satisfaction in pain control (p < .001) and overall experience (p < .01) was also found in the bupivacaine liposome group. Finally, significantly more adverse events were found in the multi-drug group versus the bupivacaine liposome group (p < .05). The study findings demonstrated a non-inferior difference, albeit not a clinically significant difference, in patient-perceived pain scores, morphine sulfate equivalence consumption, adverse events, and overall satisfaction. |
| first_indexed | 2024-12-19T04:03:10Z |
| format | Article |
| id | doaj.art-0fb1967e22f34b9491fd6ca982f30731 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-19T04:03:10Z |
| publishDate | 2016-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-0fb1967e22f34b9491fd6ca982f307312022-12-21T20:36:38ZengElsevierArthroplasty Today2352-34412016-03-0121374210.1016/j.artd.2015.05.005Improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspensionMark A. Snyder, MD0Christina M. Scheuerman, BSN, RN1Justin L. Gregg, MA2Christopher J. Ruhnke, MD3Kathryn Eten, BSN, RN4Orthopaedic Center of Excellence, TriHealth Orthopaedic and Spine Institute, Cincinnati, OH, USATriHealth Hatton Research Institute, Cincinnati, OH, USATriHealth Hatton Research Institute, Cincinnati, OH, USATriHealth Orthopaedic and Spine Institute, Cincinnati, OH, USAOrthopaedic Center of Excellence, Good Samaritan Hospital, Cincinnati, OH, USAPatients undergoing total knee arthroplasty (TKA) report low satisfaction with postoperative pain control. The purpose of this study is to examine if there is a difference in post-operative pain for TKA patients without femoral nerve block receiving an intra-operative pericapsular injection of bupivacaine liposome suspension (EXPAREL; Pacira Pharmaceuticals, Inc., San Diego, California) versus a concentrated multi drug cocktail. Seventy TKA patients were randomly assigned to either the bupivacaine liposome or the multi-drug cocktail. Post-operative pain scores, morphine sulfate equivalence consumption values, adverse events, and overall pain control satisfaction scores were collected. Patients reported significantly higher pain level for the cocktail group on post-op day 1 (p < .05) and post-op day 2 (p < .01) versus the bupivacaine liposome group. This same trend was found for morphine sulfate equivalence consumption in the PACU (p < .01) and post-op day 2 (p < .01). Higher satisfaction in pain control (p < .001) and overall experience (p < .01) was also found in the bupivacaine liposome group. Finally, significantly more adverse events were found in the multi-drug group versus the bupivacaine liposome group (p < .05). The study findings demonstrated a non-inferior difference, albeit not a clinically significant difference, in patient-perceived pain scores, morphine sulfate equivalence consumption, adverse events, and overall satisfaction.http://www.sciencedirect.com/science/article/pii/S2352344115000345Total knee arthroplastyPainPericapsular injection |
| spellingShingle | Mark A. Snyder, MD Christina M. Scheuerman, BSN, RN Justin L. Gregg, MA Christopher J. Ruhnke, MD Kathryn Eten, BSN, RN Improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspension Arthroplasty Today Total knee arthroplasty Pain Pericapsular injection |
| title | Improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspension |
| title_full | Improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspension |
| title_fullStr | Improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspension |
| title_full_unstemmed | Improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspension |
| title_short | Improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspension |
| title_sort | improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspension |
| topic | Total knee arthroplasty Pain Pericapsular injection |
| url | http://www.sciencedirect.com/science/article/pii/S2352344115000345 |
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