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
茶茶完成签到,获得积分10
刚刚
lila应助梧桐采纳,获得10
刚刚
掌心发布了新的文献求助30
1秒前
jby发布了新的文献求助10
1秒前
小鱼头发布了新的文献求助10
2秒前
科目三应助张强采纳,获得10
3秒前
汝燕发布了新的文献求助10
3秒前
111完成签到,获得积分10
4秒前
galaxy发布了新的文献求助10
4秒前
4秒前
科研通AI2S应助Yoh1220采纳,获得10
6秒前
mimi完成签到 ,获得积分10
6秒前
万能图书馆应助黯淡星采纳,获得10
8秒前
陈秋发布了新的文献求助10
9秒前
10秒前
酷波er应助小鱼采纳,获得10
10秒前
10秒前
Wxx发布了新的文献求助10
11秒前
12秒前
面向杂志编论文应助kiwi采纳,获得10
12秒前
13秒前
英俊的铭应助ling_lz采纳,获得10
13秒前
w123456发布了新的文献求助10
13秒前
科研通AI2S应助诚心的若南采纳,获得10
15秒前
szy发布了新的文献求助10
18秒前
田様应助xiuxiu采纳,获得10
20秒前
21秒前
21秒前
汝燕完成签到,获得积分10
22秒前
杜景考爱科研完成签到,获得积分20
22秒前
23秒前
小白完成签到,获得积分10
23秒前
hj123发布了新的文献求助10
24秒前
26秒前
27秒前
研友_VZG7GZ应助掌心采纳,获得10
27秒前
海盗发布了新的文献求助10
27秒前
ling_lz完成签到,获得积分10
29秒前
行者完成签到,获得积分10
29秒前
30秒前
高分求助中
Spray / Wall-interaction Modelling by Dimensionless Data Analysis 2000
Aspects of Babylonian celestial divination: the lunar eclipse tablets of Enūma Anu Enlil 500
Mathematics and Finite Element Discretizations of Incompressible Navier—Stokes Flows 500
Dictionary of socialism 350
Mixed-anion Compounds 300
Geochemistry, 2nd Edition 地球化学经典教科书第二版 300
Idoxuridine 260
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 3195658
求助须知:如何正确求助?哪些是违规求助? 2844522
关于积分的说明 8050318
捐赠科研通 2509151
什么是DOI,文献DOI怎么找? 1341478
科研通“疑难数据库(出版商)”最低求助积分说明 639124
邀请新用户注册赠送积分活动 608333