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
SciGPT应助研友_想想采纳,获得10
1秒前
2秒前
诸葛烤鸭完成签到,获得积分10
2秒前
2秒前
江南烟雨如笙完成签到 ,获得积分10
2秒前
拉宝了完成签到,获得积分10
2秒前
heolmes完成签到,获得积分10
3秒前
wlq发布了新的文献求助10
3秒前
Lvy完成签到,获得积分10
3秒前
明理寄云发布了新的文献求助30
3秒前
5552222完成签到,获得积分10
4秒前
NorthWang完成签到,获得积分10
4秒前
sky998524完成签到,获得积分10
5秒前
6秒前
学霸土豆发布了新的文献求助10
6秒前
6秒前
sh发布了新的文献求助10
7秒前
小灰灰完成签到 ,获得积分10
7秒前
自由香魔完成签到 ,获得积分10
7秒前
大卓神完成签到,获得积分10
7秒前
寒冷妙梦完成签到,获得积分10
7秒前
轩辕白竹完成签到,获得积分10
8秒前
8秒前
海风完成签到,获得积分10
8秒前
8秒前
岳莹晓完成签到 ,获得积分10
8秒前
无拘无束完成签到,获得积分10
9秒前
贪玩路灯完成签到,获得积分10
9秒前
开心不评完成签到 ,获得积分10
10秒前
慕青应助sky998524采纳,获得10
10秒前
maz123456完成签到,获得积分10
11秒前
倪好完成签到,获得积分10
11秒前
十二完成签到,获得积分10
11秒前
CipherSage应助个性灵竹采纳,获得30
12秒前
学霸土豆完成签到,获得积分10
12秒前
自然紫山完成签到,获得积分10
13秒前
abc123完成签到,获得积分10
13秒前
zhangxr完成签到 ,获得积分10
13秒前
JingP发布了新的文献求助10
13秒前
研友_想想发布了新的文献求助10
13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? 2833906
关于积分的说明 7996286
捐赠科研通 2496171
什么是DOI,文献DOI怎么找? 1331952
科研通“疑难数据库(出版商)”最低求助积分说明 636466
邀请新用户注册赠送积分活动 603660