Long Acting Local Anesthetic Reduced Need For Opioids After Knee Replacement

MedicalResearch.com Interview with:

Michael A. Mont, MD Department of Orthopaedic Surgery Cleveland Clinic Cleveland, OH

Dr. Mont

Michael A. Mont, MD
Department of Orthopaedic Surgery
Cleveland Clinic
Cleveland, OH 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Postoperative pain after total knee arthroplasty (TKA) is a major hurdle for both the patients and the orthopaedists. Many analgesic modalities are currently in use, and can be used alone or in combination in order to augment their effect. Addition of local anesthetic analgesia has been shown to improve pain control and reduce opioid consumption during postoperative period. However, the effects of this analgesia tend to dissipate with time, with the longest duration of action (bupivacaine) of approximately 12 hours. Therefore, long acting local anesthetic (liposomal bupivacaine) has been developed in order to expand the duration of effectiveness of pain relief for up to 96 hours. Many studies evaluated the effectiveness of this anesthetic and demonstrated contradictory results, however, they did not use the same methods and infiltration technique. Therefore, we conducted a prospective, randomized, double-blind, controlled study at 16 hospitals using optimal infiltration techniques. Our study demonstrated significant improvement in pain, decreased opioid consumption, increased time to first opioid rescue, more opioid free patients in liposomal bupivacaine cohort. In addition, there were no unexpected safety concerns.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: The most important finding of this study is that liposomal bupivacaine is safe and improves postsurgical pain in TKA patients.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research should concentrate on evaluating this analgesic modality in other orthopaedic subspecialties, as well as in other surgical fields in order to decrease opioid use in postsurgical patients.

MedicalResearch.com: Is there anything else you would like to add?

Response: This was a very important study, because it demonstrated how important infiltration technique is for the efficacy of the analgesic agent. We should carefully examine methods of the studies we read in order to confirm the correct technique was used.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


Local Infiltration Analgesia With Liposomal Bupivacaine Improves Pain Scores and Reduces Opioid Use After Total Knee Arthroplasty: Results of a Randomized Controlled Trial
Mont, Michael A. et al.
The Journal of Arthroplasty , Volume 0 , Issue 0 ,

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Last Updated on August 1, 2017 by Marie Benz MD FAAD