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
1秒前
科研通AI2S应助感动书竹采纳,获得10
2秒前
万能图书馆应助Robin采纳,获得10
2秒前
医魔发布了新的文献求助10
3秒前
5秒前
月成发布了新的文献求助10
6秒前
xinanfeng发布了新的文献求助10
6秒前
zhzh0618完成签到,获得积分10
7秒前
8秒前
小6s完成签到,获得积分10
8秒前
121完成签到,获得积分10
11秒前
开心完成签到,获得积分10
12秒前
英俊的铭应助酷酷羊乌云采纳,获得10
14秒前
14秒前
正直无极发布了新的文献求助20
16秒前
月成完成签到,获得积分20
16秒前
17秒前
ys发布了新的文献求助10
19秒前
大福完成签到,获得积分10
19秒前
Robin发布了新的文献求助10
19秒前
21秒前
21秒前
充电宝应助ttthz采纳,获得10
22秒前
23秒前
大壮完成签到,获得积分10
23秒前
xinanfeng完成签到,获得积分10
24秒前
丰富雅容完成签到 ,获得积分10
25秒前
1111完成签到 ,获得积分10
25秒前
25秒前
扶桑发布了新的文献求助10
25秒前
spring发布了新的文献求助10
26秒前
屾哥驳回了CHEN应助
27秒前
丘比特应助小郭采纳,获得10
28秒前
yin完成签到 ,获得积分20
28秒前
cuipanda发布了新的文献求助30
29秒前
pcf发布了新的文献求助10
29秒前
29秒前
29秒前
Cimon完成签到,获得积分10
31秒前
tangrzh完成签到,获得积分20
32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
Mathematics and Finite Element Discretizations of Incompressible Navier—Stokes Flows 500
A new species of Coccus (Homoptera: Coccoidea) from Malawi 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
Handbook on People's China (1957) 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 3189389
求助须知:如何正确求助?哪些是违规求助? 2838764
关于积分的说明 8021434
捐赠科研通 2501634
什么是DOI,文献DOI怎么找? 1335889
科研通“疑难数据库(出版商)”最低求助积分说明 637729
邀请新用户注册赠送积分活动 605784