Evaluation of the Efficacy of Liposomal Bupivacaine Infiltrated into the Posterior Capsule for Postoperative Analgesia after Total Knee Arthroplasty—A Randomized Double Blind Clinical Trial

Garg, Montey; Gupta, Puneet; Kang, Kevin; Dukshtein, Avichai; Feierman, Dennis E.

doi:10.4236/ojanes.2017.711039

Cited by 3 publications

(1 citation statement)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 Garg et al did а study to assess the effectiveness of LIA (buрivасаine) given into the роsteriоr сарsule аlоng with FNB and concluded that posterior capsular infiltration aided in relieving the post-operative pain after TKA. 12 In our study, it was observed that values of VAS were significantly lower in Group A when compared to Group B at rest and on movement, at different time frames. It depicts improved and better pain control with posterior capsular infiltration.…”

Section: Discussionmentioning

confidence: 44%

Posterior capsular infiltration with local anaesthetic cocktail during total knee arthroplasty: a prospective comparative study

Shah

Pachore²,

Patil³

et al. 2022

Int J Res Orthop

View full text Add to dashboard Cite

Background: Total knee arthroplasty offers a stable joint with excellent long-term results in osteoarthritis knee patients. The procedure is also associated with post-operative pain which can lead to delayed functional recovery in few patients. This comparative study was aimed to evaluate the effiсасy of а lосаl anaesthetic сосktаil injection with and without роsteriоr сарsulаr infiltration for роst-орerаtive раin соntrоl and early functional reсоvery in раtients undergoing simultaneous bilateral TKА.Methods: This was a prospective comparative study which involved 50 participants undergoing bilateral TKA where one knee, received LIA in anterior, medial and lateral structures of the knee as well as posterior capsule (group A) and contralateral knee received LIA in anterior, medial and lateral structures, identical to the former knee, but excluding posterior capsule region (group B). Pre-operative and post-operative parameters such as VAS, KSS and knee ROM in both knees of all the patients were noted and compared to evaluate the efficacy of PCI.Results: Comparison of VAS scores, post-operatively showed that VAS on rest and on movement was lower in group A than group B at all the time frames (p value <0.0001*). Post-operative knee ROM was higher in group A (p<0.0001). Knee society score was observed to be higher in group A than group B on 15th day and at 1 month (p<0.0001).Conclusions: The study successfully demonstrates that posterior capsular infiltration when included in LIA technique provides a better pain control and also early functional recovery after TKA.

show abstract

Section: Discussionmentioning

confidence: 44%

Posterior capsular infiltration with local anaesthetic cocktail during total knee arthroplasty: a prospective comparative study

Shah

Pachore²,

Patil³

et al. 2022

Int J Res Orthop

View full text Add to dashboard Cite

show abstract

The mornings after—periarticular liposomal bupivacaine infiltration does not improve analgesic outcomes beyond 24 hours following total knee arthroplasty: a systematic review and meta-analysis

Hussain

Brull

Sheehy

et al. 2020

Reg Anesth Pain Med

View full text Add to dashboard Cite

Periarticular local infiltration analgesia (LIA) is integral to multimodal analgesia following total knee arthroplasty (TKA); however, the duration of analgesia using traditional long-acting local anesthetics is often insufficient. LIA with slow-release liposomal bupivacaine may provide extended analgesia, but evidence of efficacy beyond the first 24 hours is conflicting. This meta-analysis compares the effects of periarticular liposomal and plain bupivacaine LIA on day 2 analgesic outcomes post-TKA. Trials comparing liposomal and plain bupivacaine LIA for TKA were sought. The two coprimary outcomes were (1) cumulative oral morphine equivalent consumption and (2) difference in area under the curve (AUC) of pooled rest pain scores on day 2 (24–48 hours) post-TKA. We also evaluated pain and analgesic consumption on day 3 (48–72 hours), functional recovery, length of hospital stay, patient satisfaction; and opioid-related side effects. Data were pooled using random-effects modeling. Seventeen trials (1836 patients) were analyzed. Comparing liposomal versus plain bupivacaine LIA for TKA failed to detect differences in morphine consumption and pain AUC on day 2 postoperatively, with mean differences of 0.54 mg (95% CI −5.09 to 6.18) and 0.08 cm/hour (95% CI −0.19 to 0.35), respectively (high-quality evidence). Secondary outcome analysis did not uncover any additional analgesic, functional or safety advantages to liposomal bupivacaine on postoperative day 2 or 3. Results indicate that liposomal and plain bupivacaine LIAs are not different for extended postoperative analgesic outcomes, including pain control, opioid consumption, as well as functional and safety outcomes on days 2 and 3 post-TKA. High-quality evidence does not support using liposomal bupivacaine LIA for TKA.

show abstract

A Case Series of 12 Patients Receiving Bilateral Transverse Abdominis Plane Blocks after Cesarean Section

Feierman¹,

Bronstein²,

Flaum³

et al. 2017

OJAnes

Self Cite

View full text Add to dashboard Cite

Transverse abdominis Plane blocks (TAP) provide effective postoperative analgesia following surgical incisions of the lower and middle abdominal wall, including those associated with cesarean section. This study investigated the efficacy of liposomal bupivacaine diluted with 0.25% bupivacaine administered in bilateral TAP blocks for post-operative analgesia after Cesarean section preformed under neuraxial anesthesia. The patients who received the TAP blocks with liposomal bupivacaine had noticeably low pain scores of 1.0 ± 1.4, 1.4 ± 2.1, 1.7 ± 1.9, 1.9 ± 3.3 and 1.9 ± 2.3 at 6, 12, 24, 48 and 72 hours respectively. Only 3 patients used oxycodone (5 mg)/acetaminophen (325 mg) postoperative. One patient took two tables of oxycodone (5 mg)/acetaminophen (325 mg) after 24 hours, a second patient used oxycodone (5 mg)/acetaminophen (325 mg) after 72 hours and the third patient was transferred to the intensive care unit (ICU) since she developed postpartum cardiac complications, and was give oxycodone (5 mg)/acetaminophen (325 mg) despite having a 0 pain score. These results suggest that patients treated bilateral TAP blocks with a mixture of liposomal and regular bupivacaine will have low pain scores, high patient satisfaction and reduce the use of postoperative narcotics.

show abstract

Evaluation of the Efficacy of Liposomal Bupivacaine Infiltrated into the Posterior Capsule for Postoperative Analgesia after Total Knee Arthroplasty—A Randomized Double Blind Clinical Trial

Cited by 3 publications

References 28 publications

Posterior capsular infiltration with local anaesthetic cocktail during total knee arthroplasty: a prospective comparative study

Posterior capsular infiltration with local anaesthetic cocktail during total knee arthroplasty: a prospective comparative study

The mornings after—periarticular liposomal bupivacaine infiltration does not improve analgesic outcomes beyond 24 hours following total knee arthroplasty: a systematic review and meta-analysis

A Case Series of 12 Patients Receiving Bilateral Transverse Abdominis Plane Blocks after Cesarean Section

Contact Info

Product

Resources

About