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European Journal of Orthopaedic Surgery & Traumatology

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01-10-2019 | Opioids | Original Article • KNEE - ARTHROPLASTY

Additive effect of continuous adductor canal block and liposomal bupivacaine periarticular injection in total knee arthroplasty

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 7/2019

Abstract

Background

Novel methods of postoperative analgesia for total knee arthroplasty (TKA) have demonstrated improved functional outcomes and decreased narcotic consumption. These approaches include continuous adductor canal blocks (CACB) and periarticular injection (PAI). There is a lack of current understanding regarding the effect of these modalities on narcotic usage, functionality, and pain when both PAI and CACB are utilized compared to PAI alone.

Methods

TKAs were performed unilaterally by a single surgeon with a standardized protocol. Patients were divided into two groups: those receiving PAI alone (n = 54) and those receiving PAI and CACB (n = 37). Patient outcomes including, narcotics usage, pain scale, and distance walked, were recorded on postoperative day (POD) zero through three.

Results

When compared with PAI alone, it was identified that concurrent use of PAI and CACB results in a statistically significant decrease in narcotics usage on POD 0, 1, 3, and total narcotic usage while admitted. Patients in the PAI and CACB group walked significantly farther than patients in the PAI only group on POD 1, 2, and 3. On POD 0, patients in the PAI and CACB reported significantly less pain with activity when compared to the PAI only group.

Conclusion

Here we identify an additive effect when utilizing both PAI and CACB for postoperative TKA analgesia. Our findings demonstrate significant decrease in patient total narcotic usage, pain scores, and an increase in walking distance when utilizing PAI and CACB compared with PAI alone. This analgesic technique may help reduce patients’ narcotic use while also increasing functional outcomes.

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Title: Additive effect of continuous adductor canal block and liposomal bupivacaine periarticular injection in total knee arthroplasty
Publication date: 01-10-2019
Keywords: Opioids
Opioids
Morphine
Physical Therapy
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 7/2019
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02452-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Additive effect of continuous adductor canal block and liposomal bupivacaine periarticular injection in total knee arthroplasty

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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