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

Liu, Shu-Qun; Chen, Xiang; Yu, Chenchen; Weng, Chengwei; Wu, Yanqin; Xiong, Juncheng; Xu, Shihao

doi:10.1097/md.0000000000006462

Cited by 22 publications

(14 citation statements)

References 28 publications

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“…investigated one RCT and five non‐RCT and concluded that LB provides similar postoperative pain relief and significantly reduces the consumption of morphine equivalents compared with FNB. However, Liu et al . analyzed two RCT and six non‐RCT and concluded that LB provides a significant beneficial effect over FNB in terms of pain reduction, and decreased the total morphine consumption.…”

Section: Discussionmentioning

confidence: 99%

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Comprehensive Comparison of Liposomal Bupivacaine with Femoral Nerve Block for Pain Control Following Total Knee Arthroplasty: An Updated Systematic Review and Meta‐Analysis

Liu

Zeng

et al. 2019

Orthopaedic Surgery

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To compare the efficacy of liposomal bupivacaine (LB) and femoral nerve block following total knee arthroplasty, we conducted this systematic review and meta-analysis. 11 trials with 2,908 patients were included in this study. The pooled data demonstrated that total morphine consumption equivalents during the hospital stay was significantly increased in FNB group. In addition, LB has significantly better outcome in view of the postoperative functional recovery, such as the odds of fall, the incidences of straight leg rise (SLR), the number of patients who can walk independently in the day of surgery,the ambulation distance at POD1, the number of patients discharged at POD1. Consistent with the faster functional recovery, liposomal bupivacaine shortens the length of hospital stay. However, there was no significant difference between LB and FNB in terms of Visual Analogue Score (VAS) during the hospital stay. All in all, liposomal bupivacaine has significantly better outcome in view of the postoperative functional recovery and the length of hospital stay compared with femoral nerve block following the total knee arthroplasty.

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Section: Discussionmentioning

confidence: 99%

“…Up to now, there have been eight meta‐analyses comparing the above three types of analgesic methods. Two of them compare the efficacy of LB with FNB following TKA. However, the conclusions they attain are not completely coherent, and there are two recently published studies not included.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Comparison of Liposomal Bupivacaine with Femoral Nerve Block for Pain Control Following Total Knee Arthroplasty: An Updated Systematic Review and Meta‐Analysis

Liu

Zeng

et al. 2019

Orthopaedic Surgery

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“…Wang et al [ 20 ] showed that liposomal bupivacaine infiltration promotes superior pain relief and less postoperative complications compared with traditional bupivacaine after total joint arthroplasty. Liu et al [ 21 ] found that local liposomal bupivacaine injection provided a significant beneficial effect over femoral nerve block in improving the pain in major orthopedic surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of liposomal bupivacaine infiltration versus interscalene nerve block for pain control in total shoulder arthroplasty

Cao

Pan

2017

Medicine

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Background:This meta-analysis aimed to compare the efficiency and safety of liposomal bupivacaine infiltration and interscalene nerve block for pain control after total shoulder arthroplasty.Methods:A systematic search was performed in Medline (1966 to May 2017), PubMed (1966 to May 2017), Embase (1980 to May 2017), ScienceDirect (1985 to May 2017) and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Reported surgical outcomes, including visual analogue scale (VAS) scores, opioid consumption, length of stay, and postoperative adverse effects including the risk of nausea and vomiting. Meta-analysis was performed using Stata 11.0 software.Results:Four RCTs including 510 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of VAS score at 12 hours (standard mean difference [SMD] = 0.272, 95% CI: −0.150 to 0.695, P = .207), 24 hours (SMD = −0.056, 95% CI: −0.458 to 0.346, P = 0.785), and 48 hours (SMD = 0.183, 95% CI: −0.148 to 0.513, P = .278). Liposomal bupivacaine infiltration groups required an equivalent amount of opioids at postoperative 12 hours (SMD = −0.039, 95% CI: −0.222 to 0.143, P = .672), 24 hours (SMD = 0.046, 95% CI: −0.136 to 0.228, P = .618) and 48 hours (SMD = −0.025, 95% CI: −0.207 to 0.157, P = .785).Conclusion:Liposomal bupivacaine infiltration provides equivalent postoperative pain control compared with interscalene nerve block following total shoulder arthroplasty. Both of them can reduce the consumption of opioids without severe adverse effects. More high-quality RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of liposomal bupivacaine infiltration with interscalene nerve block.

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“…U inervaciji kolena učestvuju n. tibialis, n. peroneus communis, zadnja grana n. obturatoriusa i n. femoralis. Izbor opšte anestezije sa endotrahealnom intubacijom nosi veliki rizik za nehirurške komplikacije u odnosu na centralnu sprovodnu anesteziju (spinal ili epidural) ili blok perifernih nerava [46][47][48] . Ipak, blokada n. ishiadicusa kod ugradnje totalne proteze kolena sa valgus deformitetom nosi rizik od ranog neprepoznavanja paralize n. ishiadicusa ili n. peroneusa.…”

Section: Artroplastike Kolenaunclassified

“…Regionalna anestezija ima prednost i kada je u pitanju kupiranje postoperativnog bola, te se tako preporučuje blokada n. saphenusa, koja omogućava ranu mobilizaciju pacijenata. U cilju postoperativne kontrole bola, kao i rane mobilizacije, danas se primenjuje multimodalni princip analgezije, u okviru koga je sve češća primena periartikularne lokalne infiltracije [46][47][48][49] . Periartikularnom infiltracijom se ubrizgava 120 ml rastvora koji sadrži lokalni anestetik (0,5% bupivakaina ili levobupivakaina 3 mg/kg), opioid (morfin 5 mg), NSAIL (ketorolak 30 mg) i adrenalin (100-300 mcg) u tri faze tokom implantacije proteze kolena.…”

Section: Artroplastike Kolenaunclassified

Anesthesia and perioperative medicine in orthopedic surgery

Srećković¹,

Milovanovic²,

Stojimanovska³

et al. 2019

Serb J Anest Inten Therapy

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Ortopedska hirurgija danas predstavlja veliki izazov za anesteziologe sa aspekta stanja pacijenta, tipa operacije, kao i položaja koji pacijent zauzima u toku operacije. U skladu sa trendom porasta gerijatrijske populacije, ortopedski pacijenti su najčešće stari sa brojnim komorbiditetima, ali i mladi, zdravi, najčešće traumatizovani, kod kojih postojanje udruženih povreda ima značajan uticaj na izbor tipa anestezije. Prilikom izbora tipa anestezije kod ortopedskih pacijenata neophodno je da se napravi adekvatna preoperativna procena i priprema i da se sagleda celokupno stanje pacijenta, a ne samo deo od značaja za hirurgiju. U okviru preoperativne pripreme kod ortopedskih pacijenata je najčešće neophodna kardiološka, pulmološka, ali i neurološka evaluacija, zatim nazalni skrining i dekolonizacija, preoperativna priprema kože, kontrola glikemije, kao i primena antibiotske profilakse. Ortopedska hirurgija ima najveći rizik za nastanak venskog tromboembolizma. Pravovremeno započinjanje tromboprofilakse, kao i njen nastavak posle operacije, kod ortopedskih pacijenata je od izuzetnog značaja. Za optimalnu upotrebu adekvatne tromboprofilakse postoji nekoliko objavljenih vodiča sa jasnim preporukama za dnevnu kliničku praksu. Poznavanje specifičnosti operacije, toka hirurgije, kao i položaja koji pacijent zauzima omogućava obezbeđivanje adekvatnih uslova rada uz minimalne gubitke krvi i komplikacije. Smanjenje krvarenja, kako intraoperativno tako i postoperativno, postiže se normovolemijskom hipotenzijom, bledom stazom uz pomoć poveske (touriquet), ali i primenom traneksamične kiseline, bilo sistemski ili lokalno. Kao hirurgija sa velikim postoperativnim zahtevima u analgeziji, u okviru multimodalnog pristupa se sve češće, pored perifernih nervnih blokova, u svakodnevnom radu primenjuje i periartikularno ubrizgavanje lokalnog anestetika. Poznavanje specifičnosti, ali i zahteva ortopedske operacije sa adekvatnom preoperativnom pripremom, iz-Revijalni članak

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

Abstract: Supplemental Digital Content is available in the text

Cited by 22 publications

References 28 publications

Comprehensive Comparison of Liposomal Bupivacaine with Femoral Nerve Block for Pain Control Following Total Knee Arthroplasty: An Updated Systematic Review and Meta‐Analysis

Comprehensive Comparison of Liposomal Bupivacaine with Femoral Nerve Block for Pain Control Following Total Knee Arthroplasty: An Updated Systematic Review and Meta‐Analysis

Comparison of liposomal bupivacaine infiltration versus interscalene nerve block for pain control in total shoulder arthroplasty

Anesthesia and perioperative medicine in orthopedic surgery

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