Differing pain control methods may offer similar outcomes in patients after unilateral TKA

DALLAS — No significant differences in pain scores and mean morphine equivalent consumption were observed among patients who received either an intra-articular or periarticular injection of bupivacaine and morphine or a periarticular injection of liposomal bupivacaine to manage pain following unilateral total knee arthroplasty, according to a presenter here.

Investigators evaluated 207 consecutive patients who underwent unilateral total knee arthroplasty (TKA) after a diagnosis of osteoarthritis, rheumatoid arthritis or post-traumatic arthritis. Patients were randomized to receive one of the following: an intra-articular injection of bupivacaine and morphine postoperatively (group 1); a periarticular injection of bupivacaine and morphine (group 2); or a periarticular injection of liposomal bupivacaine (group 3). Analyses of variance were used to compare postoperative pain using the VAS and mean morphine equivalent (MME) values.

Mean VAS scores were 3.95 in group 1, 3.97 in group 2 and 3.86 in group 3. In terms of MME consumed daily, group 1 was observed as 100.7, group 2 as 100.1 and group 3 as 98.9. Investigators found no significant differences between the cohorts for these measures.

Rajesh K. Jain

Overall, “the cheapest injection was the single-shot intra-articular injection of bupivacaine and morphine at about $16, while the liposomal bupivacaine injection was approximately 25-times as expensive,” Rajesh K. Jain, MD, MPH, said in his presentation of the American Association of Hip and Knee Surgeons (AAHKS) Clinical Award-winning study. — by Christian Ingram

Reference:

Jain RK, et al. Liposomal bupivacaine and periarticular injection are not superior to single-shot intra-articular injection for pain control in total knee arthroplasty. Presented at: American Association of Hip and Knee Surgeons Annual Meeting. Nov. 6-8, 2015; Dallas.

Disclosure: Jain reports no relevant financial disclosures.