Patient Outcomes With Periarticular Liposomal Bupivacaine Injection vs Adductor Canal Block After Primary Total Knee Arthroplasty
Overview
- Phase
- Phase 4
- Intervention
- liposomal bupivacaine
- Conditions
- Knee Osteoarthritis
- Sponsor
- Texas Orthopaedics, Sports and Rehabilitation Associates
- Enrollment
- 63
- Locations
- 1
- Primary Endpoint
- Length of stay (LOS, in days)
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
This study is being done to evaluate the outcomes of patients undergoing total knee replacement with two different methods of local pain control:shots of liposomal bupivacaine, a long acting anesthetic, directly into the knee during surgery or anesthetic delivered continuously to the adductor canal to provide long term pain relief. The goal is to try to find a standard protocol that provides the greatest pain relief for patients undergoing total knee replacement.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Male or non-pregnant female between the ages of 18-65
- •Patients willing and able to sign the informed consent
- •Patients able to comply with follow-up requirements including self-evaluations
- •Patients requiring a primary total knee replacement
- •Patients with a diagnosis of osteoarthritis, traumatic arthritis, or avascular necrosis
Exclusion Criteria
- •Revision total knee arthroplasty
- •Bilateral total knee arthroplasty
- •Patients with inflammatory arthritis
- •Patients with a body mass index (BMI) \> 40
- •Allergy to ropivacaine, bupivacaine, or other local anesthetic agents
- •Current use of opioid drugs
- •Patients with a history of total or unicompartmental reconstruction of the affected joint
- •Patients that have had a high tibial osteotomy or femoral osteotomy
- •Patients with neuromuscular or neurosensory deficiency, which would limit the ability to assess pain levels
- •Patients with a systemic or metabolic disorder leading to progressive bone deterioration
Arms & Interventions
Liposomal bupivacaine
Periarticular infiltration of 20cc of liposomal bupivacaine with 10cc of normal saline and 30cc of bupivacaine HCl administered prior to cementation of knee implants
Intervention: liposomal bupivacaine
Liposomal bupivacaine
Periarticular infiltration of 20cc of liposomal bupivacaine with 10cc of normal saline and 30cc of bupivacaine HCl administered prior to cementation of knee implants
Intervention: bupivacaine HCl
Liposomal bupivacaine
Periarticular infiltration of 20cc of liposomal bupivacaine with 10cc of normal saline and 30cc of bupivacaine HCl administered prior to cementation of knee implants
Intervention: Saline
Adductor canal and tibial nerve block
Preoperative tibial nerve block with 15cc bupivacaine HCl and adductor canal block with 20cc adductor canal block. Postoperative continuous adductor canal block with 550cc ropivacaine at 8cc per hour
Intervention: bupivacaine HCl
Adductor canal and tibial nerve block
Preoperative tibial nerve block with 15cc bupivacaine HCl and adductor canal block with 20cc adductor canal block. Postoperative continuous adductor canal block with 550cc ropivacaine at 8cc per hour
Intervention: Ropivacaine
Outcomes
Primary Outcomes
Length of stay (LOS, in days)
Time Frame: Participants will be followed for the duration of their hospital stay, an expected average of 1.5 days
Time to ambulation (in hours)
Time Frame: 2-6 hours
Secondary Outcomes
- Pain as assessed by visual analog scale (VAS) on postoperative day 3(72 hours)
- Pain as assessed by visual analog scale (VAS) on postoperative day 2(48 hours)
- Pain as assessed by visual analog scale (VAS) on postoperative day 1(24 hours)
- Postoperative complications and adverse events(2 weeks)
- Pain as assessed by visual analog scale (VAS) on postoperative day 4(96 hours)
- Pain as assessed by visual analog scale (VAS) on postoperative day 0(6 hours)
- Pain as assessed by visual analog scale (VAS) on postoperative day 5(120 hours)
- Opioid consumption in oral morphine equivalents (OMEs, in milligrams)(Participants will be followed for the duration of their hospital stay, an expected average of 1.5 days.)