Assessment of liposome bupivacaine infiltration versus continuous femoral nerve block for postsurgical analgesia following total knee arthroplasty: a retrospective cohort study

Abstract

Objective: Perioperative pain management is an important aspect of recovery from total knee arthroplasty (TKA) because severe pain can delay ambulation and hospital discharge. The objective of this retrospective sequential cohort study was to determine the impact of local infiltration analgesia using liposome bupivacaine (Exparel 1 ) when compared with a continuous femoral nerve block (FNB) following TKA. . Significantly (p < 0.05) more patients in Group A (58%) and Group B (44%) walked on POD0 than in the control group (0%); almost all patients walked on POD1. The mean (SD) distance walked was also significantly greater (p < 0.05) on POD1 in Group A (193 [203]

Local infiltration for postsurgical analgesia following total hip arthroplasty: a comparison of liposomal bupivacaine to traditional bupivacaine

“…Based on results from a previous study 26 , a power analysis determined that a sample size of 110 patients (55 per treatment group) was required to achieve 80% power to detect a between-group difference in the primary outcome measures (distance walked 193.0 ± 202.9 feet [adductor canal infiltration with bupivacaine HCl and knee infiltration with liposomal bupivacaine] vs. 210.8 ± 143.7 feet [adductor canal infiltration and knee infiltration with liposomal bupivacaine] and 46.3 ± 72.6 feet [continuous femoral nerve block with ropivacaine HCl]; LOS 3.0 ± 1.7 days vs. 2.2 ± 1.2 days and 3.2 ± 0.7 days, respectively]) at a significance level of 0.05. All statistical tests were performed against a two-sided alternative hypothesis with a significance level of 5% (a ¼ .05).…”

Comparison of periarticular anesthesia with liposomal bupivacaine with femoral nerve block for pain control after total knee arthroplasty

“…Data from 6 studies [19,21,23–26] involving 2250 patients were able to examine the VAS at 24 hours postoperatively; however, final results presented with a large heterogeneity ( I 2  = 91.5%, P  = 0.000). Pooled results revealed that PAI with LB was associated with no superior than FNB in terms of VAS at 24 hours (MD = −3.02; 95% CI −8.55 to 2.51; P  = 0.284, Fig.…”

“…Five studies [19,21,23–25] with 1653 patients were used to carry out a meta-analysis on the VAS at 48 hours and final results revealed that there was no significant difference between VAS at 48 hours (MD = −4.16; 95% CI −8.76–0.43; P  = 0.076, Fig. 3A).…”

“…Only 3 studies [21,23,25] reported the VAS at 72 hours and pooled results indicated that PAI with LB has similar pain control at 72 hours (MD = −0.49; 95% CI −4.22–3.23; P  = 0.795, Fig. 4A).…”

“…Five studies [19,21,23–25] addressed the total morphine consumption between LB group and FNB group. There was a high heterogeneity between the included studies ( I 2  = 95.9%, P  = 0.000) and thus a random-model was performed.…”