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
1秒前
1秒前
情怀应助LLL采纳,获得10
1秒前
科研一霸完成签到,获得积分10
2秒前
111发布了新的文献求助10
3秒前
3秒前
怡然夏山关注了科研通微信公众号
3秒前
浅尝离白应助mount采纳,获得30
4秒前
怡然夏山关注了科研通微信公众号
4秒前
Remi完成签到,获得积分20
4秒前
白了个白完成签到 ,获得积分10
5秒前
qinglingdao完成签到,获得积分10
5秒前
wxwx发布了新的文献求助10
5秒前
5秒前
6秒前
7秒前
8秒前
tdtk完成签到,获得积分10
8秒前
9秒前
幻想Cloudy完成签到 ,获得积分0
10秒前
花花发布了新的文献求助10
10秒前
11秒前
干净雅旋发布了新的文献求助10
11秒前
陈M雯发布了新的文献求助10
11秒前
哈哈哈发布了新的文献求助10
11秒前
wuzhizhiya应助qinglingdao采纳,获得10
12秒前
乌拉拉发布了新的文献求助10
13秒前
13秒前
充电宝应助米六采纳,获得10
13秒前
14秒前
淡然的怜容完成签到,获得积分10
15秒前
15秒前
共享精神应助Remi采纳,获得10
16秒前
16秒前
17秒前
璆璆满分发布了新的文献求助10
18秒前
Lucas应助奇奇采纳,获得10
19秒前
Atopos发布了新的文献求助10
19秒前
浮云发布了新的文献求助30
20秒前
怡然夏山发布了新的文献求助10
20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 3182927
求助须知:如何正确求助?哪些是违规求助? 2833134
关于积分的说明 7992653
捐赠科研通 2495258
什么是DOI,文献DOI怎么找? 1331430
科研通“疑难数据库(出版商)”最低求助积分说明 636286
邀请新用户注册赠送积分活动 603355