The AAHKS Clinical Research Award: Liposomal Bupivacaine and Periarticular Injection Are Not Superior to Single-Shot Intra-articular Injection for Pain Control in Total Knee Arthroplasty

Jain, Rajesh; Porat, Manny; Klingenstein, Gregory G.; Reid, Jeremy J.; Rm, Post; Schoifet, Scott D.

doi:10.1016/j.arth.2016.03.036

Cited by 63 publications

(45 citation statements)

References 7 publications

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“…30 The cost of treatment was reported in four studies. Jain et al 18 reported the mean cost of pain control during the perioperative and postoperative periods, while Collis et al 17 reported the total cost of injection. Both studies reported that the cost of liposomal bupivacaine was significantly higher than that of traditional PAI.…”

Section: Discussionmentioning

confidence: 99%

“…2). [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Four studies 7,13,15,18 compared other groups in addition to liposomal bupivacaine and traditional PAI, so we selected only the data related to liposomal bupivacaine and traditional PAI for analysis. Finally, nine RCTs and seven nRCTs were included in our review (►Table 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…25,26 Several independent studies comparing liposomal bupivacaine and traditional PAI for pain control after TKA have been reported in recent years. [18][19][20]22 Although some reviews or meta-analyses of these studies have previously been performed, 27,28 newer studies have become available in the literature in recent years. Therefore, we performed a meta-analysis including additional trials and a greater caseload to evaluate the clinical outcomes of liposomal bupivacaine and traditional PAI for postoperative pain control after TKA.…”

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confidence: 99%

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A Meta-Analysis Comparing Liposomal Bupivacaine and Traditional Periarticular Injection for Pain Control after Total Knee Arthroplasty

et al. 2018

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Liposomal bupivacaine is a novel method for pain control after total knee arthroplasty (TKA), but recent studies showed no advantage for patients undergoing TKA compared with traditional periarticular injection (PAI). The purpose of this analysis was to compare the clinical outcomes between liposomal bupivacaine treatment and traditional PAI. We retrospectively reviewed data from 16 clinical trials in published databases from their inception to June 2017. The primary outcome was postoperative Visual Analogue Scale (VAS) score and secondary outcomes included opiate usage, narcotic consumption, range of motion, and length of stay. Nine randomized controlled trials and seven nonrandomized controlled trials involving 924 liposomal bupivacaine cases and 1,293 traditional PAI cases were eligible for inclusion in the meta-analysis. No differences were detected in most of the clinical outcomes, except for postoperative VAS within 12 hours and length of stay. This analysis showed that liposomal bupivacaine is not associated with significant improvement in postoperative pain control or other outcomes in TKA compared with PAI.

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Section: Discussionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

mentioning

confidence: 99%

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A Meta-Analysis Comparing Liposomal Bupivacaine and Traditional Periarticular Injection for Pain Control after Total Knee Arthroplasty

et al. 2018

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“…[ [24][25][26][27][28][29][30]. The use of LB in the spine has not been investigated near the extent as it has been in TKA and the results from these studies have yet to yield a definitive conclusion.…”

Section: Resultsmentioning

confidence: 99%

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Gannon¹

2018

SCTI

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“…This is a double Open Journal of Anesthesiology blinded study as both patient and investigator were unaware of patient's actual treatment. In other studies where the surgeon is an investigator, double blinding is not possible as liposomal bupivacaine has a different consistency than control group drugs [28]. In other studies showing superior results with liposomal bupivacaine use, the medication was compared with a femoral nerve block or intrathecal morphine.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of Liposomal Bupivacaine Infiltrated into the Posterior Capsule for Postoperative Analgesia after Total Knee Arthroplasty—A Randomized Double Blind Clinical Trial

Garg¹,

Gupta²,

Kang³

et al. 2017

OJAnes

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Achieving adequate control of postsurgical pain remains a challenge in patients undergoing Total Knee Arthroplasty (TKA). The objective of this study was to assess if liposomal bupivacaine injected into the posterior capsule, in combination with a femoral nerve block and multimodal pain control regimen, would result in better pain control. The two groups were similar with regards to demographics and method of intraoperative anesthesia. Infiltration into the posterior capsule with liposomal bupivacaine had significantly lower resting pain scores compared to the saline group. Patients in the liposomal bupivacaine group also used slightly less breakthrough narcotic (5.75 to 4.31 mg of morphine equivalence). We recommend the use of infiltration of liposomal bupivacaine into the posterior capsule as an adjunct in multimodal analgesia in TKA patients to reduce pain and resultant narcotic use.

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The AAHKS Clinical Research Award: Liposomal Bupivacaine and Periarticular Injection Are Not Superior to Single-Shot Intra-articular Injection for Pain Control in Total Knee Arthroplasty

Cited by 63 publications

References 7 publications

A Meta-Analysis Comparing Liposomal Bupivacaine and Traditional Periarticular Injection for Pain Control after Total Knee Arthroplasty

A Meta-Analysis Comparing Liposomal Bupivacaine and Traditional Periarticular Injection for Pain Control after Total Knee Arthroplasty

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Evaluation of the Efficacy of Liposomal Bupivacaine Infiltrated into the Posterior Capsule for Postoperative Analgesia after Total Knee Arthroplasty—A Randomized Double Blind Clinical Trial

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