Abstract
Achieving adequate control of postsurgical pain remains a challenge in patients undergoing Total Knee Arthroplasty (TKA). The objective of this study was to assess if liposomal bupivacaine injected into the posterior capsule, in combination with a femoral nerve block and multimodal pain control regimen, would result in better pain control. The two groups were similar with regards to demographics and method of intraoperative anesthesia. Infiltration into the posterior capsule with liposomal bupivacaine had significantly lower resting pain scores compared to the saline group. Patients in the liposomal bupivacaine group also used slightly less breakthrough narcotic (5.75 to 4.31 mg of morphine equivalence). We recommend the use of infiltration of liposomal bupivacaine into the posterior capsule as an adjunct in multimodal analgesia in TKA patients to reduce pain and resultant narcotic use.
Highlights
Total knee arthroplasty (TKA) is often undertaken in patients with end-stage knee arthritis
Achieving adequate control of postsurgical pain remains a challenge in patients undergoing Total Knee Arthroplasty (TKA)
1) Assess the efficacy of pain control of liposomal bupivacaine when injected into the posterior knee capsule along with femoral nerve block after total knee arthroplasty
Summary
Total knee arthroplasty (TKA) is often undertaken in patients with end-stage knee arthritis. TKA can be a very successful procedure, results from patient surveys suggest there can be a high incidence of moderate to severe post-surgical pain [1] [2]. United States has doubled in the last decade. Acute pain management remains a challenge [3] [4] [5]. Poor pain control has an established relationship with delays in rehabilitation, prolonged hospital stays and the potential of progression to chronic pain [6]. The Joint Commission on Accreditation of Healthcare Organization (JCAHO) has endorsed comprehensive assessment and adequate treatment of post-operative pain by developing standardized guidelines [7]
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