The Learning Curve Associated with the Administration of Intra-Articular Liposomal Bupivacaine for Total Knee Arthroplasty: A Pilot Study.

医学 渗透(HVAC) 布比卡因 麻醉 类阿片 吗啡 关节置换术 局部麻醉剂 可视模拟标度 全膝关节置换术 外科 内科学 热力学 物理 受体
作者
Anton Khlopas,Randa K. Elmallah,Morad Chughtai,George Yakubek,Mhamad Faour,Alison K. Klika,Carlos A. Higuera,Robert M. Molloy,Michael W. Kattan
出处
期刊:PubMed 卷期号:30: 314-320 被引量:12
链接
标识
摘要

Liposomal bupivacaine is a long-acting, local, injectable anesthetic that is used to potentially mitigate post-operative pain after total knee arthroplasty (TKA). In addition, it may reduce opioid use in the post-operative period and shorten lengths-of-stay (LOS). There have been mixed results in the literature with regards to its efficacy, which raises questions regarding the injection technique used. Therefore, we evaluated the learning curve associated with injection techniques prior to, and after, formal teaching. Specifically, we compared differences in: 1) opioid use; 2) LOS; 3) pain intensity; and 4) discharge disposition in patients who did not receive liposomal bupivacaine (no infiltration cohort), received liposomal bupivacaine with less optimal technique (subpar infiltration), and received liposomal bupivacaine with appropriate technique (optimal infiltration) during their primary TKA.A 1:1:1 ratio of 54 consecutive cases of patients who had no liposomal bupivacaine infiltration, those who had subpar infiltration, and those who had optimal infiltration were included. To evaluate opioid use, the dosages were obtained and converted to their respective morphine milliequivalents (mEq). The total mEq usage was obtained for the day of surgery through post-operative day (POD) 3. LOS was recorded in days. Pain scores were calculated using the visual analogue scale (VAS), obtained from the first post-operative physical therapy note. Discharge status was recorded as discharged to home or rehabilitation. We used an ANOVA test for continuous and X2-square test for categorical variables.When compared to patients who had no infiltration, patients who had subpar infiltration had significantly lower opioid use on day 0, while patients who had optimal infiltration had lower opioid use on post-operative day (POD) 0 and 3. When comparing techniques, opioid use was lower on day 3 for patients who had optimal, as compared to subpar technique. However, LOS and VAS were not significantly different among the three groups. The rehab discharge rate was lower for patients who had optimal as compared to subpar technique.There is a learning curve associated with liposomal bupivacaine use, and incorporating an appropriate technique can markedly affect post-operative outcomes. This should be taken into account when evaluating the potential benefits of this peri-articular injection. It appears that liposomal bupivacaine may decrease opioid use and pain scores when optimal infiltration techniques are used.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
079发布了新的文献求助10
2秒前
庄大金发布了新的文献求助10
2秒前
明理如凡完成签到 ,获得积分10
3秒前
YH完成签到,获得积分10
3秒前
时尚的莛发布了新的文献求助10
5秒前
归诚发布了新的文献求助10
5秒前
木偶橘发布了新的文献求助10
7秒前
7秒前
OIC完成签到,获得积分10
8秒前
HJBF666完成签到 ,获得积分10
9秒前
wwhhyy完成签到,获得积分10
10秒前
12秒前
一只特立独行的朱完成签到,获得积分10
13秒前
时尚的莛完成签到,获得积分10
13秒前
wangledian发布了新的文献求助10
15秒前
15秒前
李爱国应助真实的怜容采纳,获得10
16秒前
17秒前
HEHE完成签到,获得积分10
18秒前
快乐小熊猫完成签到,获得积分10
18秒前
samuel完成签到,获得积分10
19秒前
19秒前
abao完成签到 ,获得积分10
21秒前
liujie01发布了新的文献求助10
22秒前
我不爱池鱼应助liu103154采纳,获得10
23秒前
SunDeer完成签到 ,获得积分10
24秒前
周晴完成签到 ,获得积分10
25秒前
英姑应助yiyue采纳,获得10
25秒前
HEHE发布了新的文献求助10
31秒前
马小懂完成签到,获得积分10
31秒前
小黑板完成签到,获得积分10
33秒前
gloval完成签到,获得积分10
34秒前
星星完成签到,获得积分10
35秒前
CipherSage应助明理如凡采纳,获得10
35秒前
Chingvir发布了新的文献求助20
36秒前
JackMa应助Bonnie采纳,获得10
38秒前
123456完成签到,获得积分10
42秒前
43秒前
但是完成签到,获得积分10
44秒前
高分求助中
Spray / Wall-interaction Modelling by Dimensionless Data Analysis 2000
Evolution 3rd edition 1500
保险藏宝图 1000
Lire en communiste 1000
Mantiden: Faszinierende Lauerjäger Faszinierende Lauerjäger 700
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 700
Mathematics and Finite Element Discretizations of Incompressible Navier—Stokes Flows 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3184566
求助须知:如何正确求助?哪些是违规求助? 2834896
关于积分的说明 8002060
捐赠科研通 2497295
什么是DOI,文献DOI怎么找? 1332766
科研通“疑难数据库(出版商)”最低求助积分说明 636685
邀请新用户注册赠送积分活动 604062