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Liposomal bupivacaine infiltration likely reduces opioid use after TKA
In the first 24 hours after patients underwent primary total knee arthroplasty, opioid used was reduced with a local infiltration of liposomal bupivacaine, according to results of a recently published study.
Researchers retrospectively evaluated the results of 199 patients from the Veterans Affairs Medical Center who underwent primary total knee arthroplasty (TKA). Of these patients, 98 were given a periarticular injection of liposomal bupivacaine. Opioid use after discharged from the post-anesthesia care unit (PACU) was the primary outcome of the study, followed by perioperative opioid use, opioid use in the PACU, average pain scores, use of a PCA, naxolone use in the PACU and surgical ward, anti-emetic use in PACU and surgical ward, and days to discharge.
Results showed the median opioid use within the first 24 hours after surgery was lower for patients who were given liposomal bupivacaine following primary TKA compared with patients who were not given the injection. Investigators noted in the first 24 hours following surgery, there was also a reduction in the use of patient-controlled analgesia among patients who were given liposomal bupivacaine vs. those who were not given the injection. The use of anti-emetics also decreased within 24 hours after surgery and in the PACU for patients who received liposomal bupivacaine.
According to researchers, there were more patients without pain in the PACU for the liposomal bupivacaine group vs. the comparison group. Patients given the liposomal bupivacaine saw improvements in median pain scores in the PACU compared with patients who were not given liposomal bupivacaine; however, at 48 hours, 72 hours and 96 hours, patients who received liposomal bupivacaine had greater median pain scores. The two groups were not different regarding median length of stay. ‒ by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.