Related ACE Reports
- Published: Mar 2017
- ACE Report #9564
AAOS2017: Combined FNB-SNB, PAI with ropivacaine, or PAI with liposomal bupivacaine in TKA
Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
CONFERENCE ACE REPORTS
This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.
Why was this study needed now?
A number of analgesia methods have been developed for use in total knee arthroplasty. Of these methods, femoral nerve block, with or without additional sciatic nerve block, remains one of the most common. More recently, periarticular infiltration (PAI) analgesia has emerged as a possible alternative. PAI employs local anesthetic, with or without other constituents, within the periarticular tissues to managed pain in the immediate hours following surgery. Liposomal bupivacaine is a newer local anesthetic preparation, developed with the intention of lengthening the duration of analgesia relative to other standard local anesthetics. However, consistent data in support of this claim is lacking. This study sought to compare the analgesic efficacy of these three pain management methods following total knee arthroplasty.
What was the principal research question?
In total knee arthroplasty, what is the comparative efficacy of postoperative analgesia between continuous femoral nerve block plus a single-shot sciatic nerve block, periarticular infiltration analgesia with ropivacaine, ketorolac, and epinephrine, and periarticular infiltration analgesia with liposomal bupivacaine, ketorolac, and epinephrine when assessed on the day of surgery and on postoperative day 1?
|Population:||165 patients scheduled for primary unilateral total knee arthroplasty. All patients received standard preoperative and postoperative oral analgesia.|
|Intervention:||PAI Lipo: Patients were administered periarticular injection analgesia with a mixture of liposomal bupivacaine, ketorolac, and epinephrine|
|Comparison:||PAI Ropi: Patients were administered periarticular injection analgesia with a mixture of liposomal bupivacaine, ketorolac, and epinephrine FNB-SNB: Patients received a continuous femoral catheter and a single-shot sciatic nerve block.|
|Outcomes:||Reported outcome measures included pain on a visual analog scale (VAS) and opioid consumption.|
|Methods:||RCT; Single center|
|Time:||Patients were assessed on the day of surgery and on postoperative day 1.|
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.