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Liposomal bupivacaine with an adductor canal
block was found to be better than femoral nerve block in terms of cost, length
of stay, opioid related adverse effects and readmissions.
The investigators at the Department of Orthopaedic Surgery, Cleveland Clinic, Ohio found out that a periarticular injection of liposomal bupivacaine with an adductor canal block (LB+ACB) exhibited a comparative efficacy as the femoral nerve block (FNB) for controlling postoperative pain following total knee arthroplasty.
Total knee
arthroplasty (TKA) presents significant postoperative pain, which needs to be
appropriately managed. This study focused on evaluating the proper regimen to
manage this postoperative pain.
The retrospective analysis of the 557 consecutive primary TKA cases was conducted at a single hospital from 2010 to 2014. Out of 557 cases, only 390 remained after matching the enrollment criteria. A comparison was done between inpatient and post-discharge variables linked to pain, cost, narcotic use, and healthcare resource utilization.
No significant
differences were observed in the demographics between the two groups. The
patients of the FNB group utilized fewer narcotics overall than LB+ACB group.
Both approaches provide relief from pain during the analysis, but for some of
the subjects, LB+ACB is not the first option.
Surg Technol Int.
A Comparison of Pain Management Protocols Following Total Knee Arthroplasty: Femoral Nerve Block versus Periarticular Injection of Liposomal Bupivacaine with an Adductor Canal Block.
Sandhu S et al.
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