title: Does Local Soft Tissue Infiltration With a Liposomal Bupivacaine Cocktail Have a Synergistic Effect When Combined With Single-Shot Adductor Canal Peripheral Nerve Block in Knee Arthroplasty?
abstract: The purpose of this study was to determine if periarticular injection (PAI) with liposomal bupivacaine cocktail has a synergistic effect on pain relief with a single-injection adductor canal block in knee arthroplasty. Three hundred thirty-three knee arthroplasties were divided into three groups. Group 1 received general anesthesia (GA) and liposomal bupivacaine PAI. Group 2 received GA, peripheral nerve block (PNB), and liposomal bupivacaine PAI. Group 3 received GA, PNB, and ``plain'' ropivacaine PAI. Remaining perioperative multimodal medications and therapies were identical. There were no statistically significant differences in average narcotic use between any groups on the day of surgery, postoperative day 1, or postoperative day 2. Group 3 had the lowest postoperative nausea. Group 2 had the least pruritis. The current study failed to demonstrate a decrease in narcotic consumption with the combination of liposomal bupivacaine PAI and PNB. This study supports previous studies demonstrating that liposomal bupivacaine PAI provides similar outcomes to PNB.
authors.affiliation: Joint Implant Surgeons, Inc., New Albany, Ohio.
authors.forename: Zachary C
authors.initials: ZC
authors.lastname: Lum
authors.forename: Adolph V
authors.initials: AV
authors.lastname: Lombardi
authors.forename: Jason
authors.initials: J
authors.lastname: Hurst
authors.forename: Michael
authors.initials: M
authors.lastname: Morris
authors.forename: Keith
authors.initials: K
authors.lastname: Berend
mesh_terms: D000368:Aged; D000577:Amides / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage*; D016022:Case-Control Studies; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D007902:Length of Stay; D008081:Liposomes; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D012189:Retrospective Studies; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008081:Liposomes; D000077212:Ropivacaine; D002045:Bupivacaine