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
大王869完成签到 ,获得积分10
1秒前
2秒前
张小小完成签到,获得积分10
2秒前
3秒前
5秒前
顺利的飞荷完成签到,获得积分0
6秒前
乐观伟泽完成签到,获得积分10
6秒前
7秒前
7秒前
梅子完成签到 ,获得积分10
7秒前
thuuu完成签到,获得积分10
8秒前
棠以秧完成签到 ,获得积分10
9秒前
mercury发布了新的文献求助10
11秒前
吴红波发布了新的文献求助10
11秒前
不配.应助茶博士采纳,获得10
12秒前
布通发布了新的文献求助10
13秒前
医生小白完成签到 ,获得积分10
13秒前
Axs完成签到,获得积分10
14秒前
贤惠的紫菜完成签到 ,获得积分10
16秒前
18秒前
lixiniverson完成签到 ,获得积分10
20秒前
上官若男应助fzzzzlucy采纳,获得10
20秒前
xiaozhou完成签到,获得积分10
21秒前
布通完成签到,获得积分10
21秒前
8888拉完成签到,获得积分10
21秒前
21秒前
小栗发布了新的文献求助10
23秒前
追寻的梦凡完成签到 ,获得积分10
23秒前
23秒前
sunaijia应助lixiaxia采纳,获得10
26秒前
2Y发布了新的文献求助30
26秒前
ZCY完成签到,获得积分10
27秒前
27秒前
天朗发布了新的文献求助30
28秒前
别凡发布了新的文献求助10
28秒前
白昼の月完成签到 ,获得积分0
29秒前
不配.应助小栗采纳,获得10
30秒前
妮妮完成签到 ,获得积分10
33秒前
努力搞科研完成签到,获得积分10
34秒前
Azyyyy完成签到,获得积分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 3190726
求助须知:如何正确求助?哪些是违规求助? 2839959
关于积分的说明 8026385
捐赠科研通 2503052
什么是DOI,文献DOI怎么找? 1336685
科研通“疑难数据库(出版商)”最低求助积分说明 637950
邀请新用户注册赠送积分活动 606263