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
Owen应助王金金采纳,获得10
刚刚
2秒前
今后应助zzz采纳,获得10
2秒前
夕荀发布了新的文献求助10
3秒前
小小的梦想完成签到,获得积分10
3秒前
悦耳真完成签到,获得积分20
4秒前
Oatmeal5888发布了新的文献求助10
4秒前
4秒前
5秒前
野性的雁菡完成签到 ,获得积分10
5秒前
孙星发布了新的文献求助20
6秒前
小蘑菇应助Dkakxncnsksl采纳,获得10
7秒前
赖向珊发布了新的文献求助10
8秒前
华仔应助luoxuefei采纳,获得10
8秒前
pp‘s完成签到 ,获得积分10
8秒前
谦让芹菜完成签到,获得积分10
9秒前
韭菜盒子发布了新的文献求助10
10秒前
小二郎应助崔家荣采纳,获得10
10秒前
希望天下0贩的0应助CC采纳,获得10
10秒前
正直白梅完成签到,获得积分20
10秒前
夕荀完成签到,获得积分10
11秒前
11秒前
赘婿应助Mona采纳,获得10
12秒前
研友_VZG7GZ应助wang5945采纳,获得10
12秒前
别push我完成签到,获得积分10
13秒前
黑暗精灵发布了新的文献求助10
13秒前
是是是完成签到,获得积分10
13秒前
邪恶小天使完成签到 ,获得积分10
13秒前
14秒前
14秒前
BK1BK22完成签到 ,获得积分10
14秒前
16秒前
Diamond完成签到 ,获得积分10
16秒前
16秒前
17秒前
Lan完成签到 ,获得积分10
19秒前
随机子应助韭菜盒子采纳,获得10
19秒前
斯文问旋发布了新的文献求助10
20秒前
zyc发布了新的文献求助10
20秒前
高分求助中
Spray / Wall-interaction Modelling by Dimensionless Data Analysis 2000
Evolution 3rd edition 1500
Mantiden: Faszinierende Lauerjäger Faszinierende Lauerjäger 700
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 700
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
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 3187181
求助须知:如何正确求助?哪些是违规求助? 2837087
关于积分的说明 8013241
捐赠科研通 2499689
什么是DOI,文献DOI怎么找? 1334515
科研通“疑难数据库(出版商)”最低求助积分说明 637194
邀请新用户注册赠送积分活动 605102