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Adductor Canal Block Versus Liposomal Bupivacaine in TKA

2019-09-17 02:47:39 | BioPortfolio

Summary

This is a randomized prospective study of 60 patients undergoing total knee arthroplasty evaluating the clinical outcomes of liposomal bupivacaine periarticular injections (PAI) when compared to single shot adductor canal block using bupivacaine HCl.

Description

Total knee arthroplasty(TKA) is an effective solution for end stage arthritis of the knee; however, post-surgical pain can be difficult to manage and the optimal peri-operative pain management strategy has not been established. This study serves to evaluate the clinical outcomes of liposomal bupivacaine PAI when compared to single shot adductor canal block using bupivacaine HCl in patients undergoing a TKA. The investigators hypothesized that peri-articular injection with liposomal bupivacaine would not be inferior to an adductor canal block using bupivacaine HCl. A total of 60 patients were recruited. Thirty patients were randomized to receive intraoperative liposomal bupivacaine periarticular injection, and another thirty patients randomized to receive a pre-operative adductor canal block using bupivacaine. Both groups otherwise received standard pain management strategies peri-operatively. The primary outcome of interest was post-operative pain, which was measured using the Visual Analog Scale (VAS). Secondary measures included changes in patient function which was measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee range of motion, post-operative ambulation distance, and hospital length of stay.

Study Design

Conditions

Total Knee Arthroplasty

Intervention

Liposomal Bupivacaine Peri-articular Injection, Adductor canal block

Location

Good Samaritan Regional Medical Center
Corvallis
Oregon
United States
97330

Status

Completed

Source

Good Samaritan Regional Medical Center, Oregon

Results (where available)

View Results

Links

Published on BioPortfolio: 2019-09-17T02:47:39-0400

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Medical and Biotech [MESH] Definitions

Interruption of sympathetic pathways, by local injection of an anesthetic agent, at any of four levels: peripheral nerve block, sympathetic ganglion block, extradural block, and subarachnoid block.

A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)

The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.

The joint that is formed by the inferior articular and malleolar articular surfaces of the TIBIA; the malleolar articular surface of the FIBULA; and the medial malleolar, lateral malleolar, and superior surfaces of the TALUS.

Preparatory activities in ROOT CANAL THERAPY by partial or complete extirpation of diseased pulp, cleaning and sterilization of the empty canal, enlarging and shaping the canal to receive the sealing material. The cavity may be prepared by mechanical, sonic, chemical, or other means. (From Dorland, 28th ed, p1700)

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