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
科目三应助科研通管家采纳,获得10
刚刚
彭于晏应助科研通管家采纳,获得10
刚刚
郑郑郑幸运完成签到 ,获得积分10
1秒前
人文完成签到 ,获得积分10
3秒前
孙成成完成签到 ,获得积分10
4秒前
华仔应助Eva采纳,获得10
5秒前
彭于晏应助懵懂的梦秋采纳,获得10
5秒前
大地完成签到,获得积分10
6秒前
秋半梦发布了新的文献求助10
6秒前
Xxxxxxx完成签到 ,获得积分10
7秒前
永远爱刻晴完成签到 ,获得积分10
7秒前
smile发布了新的文献求助10
8秒前
无辜不言完成签到,获得积分10
8秒前
孙孙孙啊完成签到,获得积分10
8秒前
9秒前
13秒前
懵懂的梦秋完成签到,获得积分10
14秒前
14秒前
李金奥发布了新的文献求助10
16秒前
Eric完成签到 ,获得积分10
16秒前
17秒前
ssw完成签到,获得积分10
17秒前
long完成签到 ,获得积分10
18秒前
秋半梦发布了新的文献求助10
19秒前
ssw发布了新的文献求助10
21秒前
Ampace小老弟完成签到 ,获得积分10
21秒前
清脆的秋寒完成签到,获得积分10
22秒前
kmyang发布了新的文献求助10
23秒前
24秒前
柠檬茶完成签到 ,获得积分10
26秒前
buno应助azure采纳,获得10
26秒前
大模型应助smile采纳,获得10
26秒前
派总完成签到,获得积分10
26秒前
matt完成签到,获得积分10
26秒前
SciKid524完成签到 ,获得积分10
31秒前
TobyGarfielD完成签到 ,获得积分10
32秒前
32秒前
Wen完成签到 ,获得积分10
33秒前
猴王完成签到,获得积分10
33秒前
34秒前
高分求助中
Evolution 3rd edition 1500
保险藏宝图 1000
Lire en communiste 1000
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
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 3183774
求助须知:如何正确求助?哪些是违规求助? 2833826
关于积分的说明 7995716
捐赠科研通 2496089
什么是DOI,文献DOI怎么找? 1331890
科研通“疑难数据库(出版商)”最低求助积分说明 636458
邀请新用户注册赠送积分活动 603625