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
3秒前
5秒前
6秒前
CodeCraft应助呼呼呼采纳,获得10
8秒前
叶琳发布了新的文献求助10
8秒前
梁_发布了新的文献求助10
8秒前
22222发布了新的文献求助30
9秒前
9秒前
踏实凡梦完成签到 ,获得积分10
10秒前
13秒前
lxt发布了新的文献求助10
13秒前
13秒前
湖里发布了新的文献求助10
14秒前
Zurlliant完成签到,获得积分10
15秒前
16秒前
16秒前
zkk发布了新的文献求助20
17秒前
梁_完成签到,获得积分10
17秒前
17秒前
17秒前
yecheng完成签到,获得积分10
18秒前
开心榴莲大王完成签到 ,获得积分10
18秒前
斯文败类应助湖里采纳,获得10
19秒前
tt666发布了新的文献求助10
20秒前
prayme4发布了新的文献求助10
21秒前
呼呼呼发布了新的文献求助10
21秒前
20231125完成签到,获得积分10
22秒前
英俊的铭应助tt666采纳,获得10
25秒前
JOKER完成签到 ,获得积分10
25秒前
毅诚菌完成签到,获得积分10
27秒前
rui完成签到,获得积分10
27秒前
科研混子关注了科研通微信公众号
27秒前
jyy应助诸葛晴天采纳,获得10
30秒前
lxt完成签到,获得积分10
30秒前
南宫萍完成签到,获得积分10
31秒前
joshar完成签到,获得积分10
31秒前
zkk完成签到,获得积分10
34秒前
慕容雅柏完成签到 ,获得积分10
35秒前
科目三应助科研通管家采纳,获得10
35秒前
Ray羽曦~应助科研通管家采纳,获得10
35秒前
高分求助中
Spray / Wall-interaction Modelling by Dimensionless Data Analysis 2000
ALA生合成不全マウスでの糖代謝異常の分子機構解析 520
安全防范技术与工程 500
Mathematics and Finite Element Discretizations of Incompressible Navier—Stokes Flows 500
2-Acetyl-1-pyrroline: an important aroma component of cooked rice 500
A real-time energy management strategy based on fuzzy control and ECMS for PHEVs 400
2024 Medicinal Chemistry Reviews 400
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 3190618
求助须知:如何正确求助?哪些是违规求助? 2839902
关于积分的说明 8025837
捐赠科研通 2502907
什么是DOI,文献DOI怎么找? 1336666
科研通“疑难数据库(出版商)”最低求助积分说明 637915
邀请新用户注册赠送积分活动 606166