title: Continuous infusion of bupivacaine following total knee arthroplasty: a randomized control trial pilot study.
abstract: An RCT pilot-study was conducted to assess efficacy of a 48-h continuous local infiltration of intra-articular bupivacaine (0.5% at 2 cc/h) versus placebo (0.5% saline at 2 cc/h) in decreasing PCA morphine consumption following TKA. Secondary outcomes included 48-h VAS pain, opioid side effects, length of stay, and knee function scores up to 1-year postoperatively. Of 67 randomized patients, 49 completed the trial including 24 bupivacaine, and 25 placebo patients. Mean 48-h PCA morphine consumption did not differ significantly between treatment (39 mg ± 27.1) and placebo groups (53 mg ± 30.4) (P = .137). The intervention did not improve pain scores, or any other outcome studied. Given study results we would conclude that analgesia outcomes with a multimodal analgesia regimen are not significantly improved by adding 48 h of 0.5% bupivacaine infiltration at 2 cc/h.
authors.affiliation: Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada.
authors.forename: Dale
authors.initials: D
authors.lastname: Williams
authors.forename: Danielle
authors.initials: D
authors.lastname: Petruccelli
authors.forename: James
authors.initials: J
authors.lastname: Paul
authors.forename: Liz
authors.initials: L
authors.lastname: Piccirillo
authors.forename: Mitch
authors.initials: M
authors.lastname: Winemaker
authors.forename: Justin
authors.initials: J
authors.lastname: de Beer
mesh_terms: D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D010865:Pilot Projects
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine