Among adult patients who underwent unilateral total knee arthroplasty, a periarticular injection of liposomal bupivacaine was found to be non-inferior to femoral nerve block alone for combined pain scores, according to results of this study.
Researchers randomly assigned 80 patients undergoing total knee arthroplasty to receive either femoral nerve block (FNB) or 226 mg of liposomal bupivacaine (Exparel; Pacira Pharmaceuticals Inc., Parsipanny, NJ). The study’s primary outcome measure was pain control after surgery, and secondary outcome measures included passive range of motion, nausea and vomiting, narcotic consumption, ambulation distance and length of stay.
Results showed no significant differences in pain control between the two groups, according to the researchers. In addition, there were no significant differences observed between the groups with regard to pain, nausea and vomiting.
Patients in the FNB group experienced improved flexion in average passive range of motion, whereas patients in the liposomal bupivacaine had improved early ambulation and shorter length of hospital stays.
Although total opioid consumption between the FNB and liposomal bupivacaine groups demonstrated no statistically significant difference, researchers found a significant difference between the groups on postoperative day 0 and postoperative day 1. Patients in the FNB group required significantly fewer opioids on postoperative day 0 vs. the liposomal bupivacaine group, but the liposomal bupivacaine group required significantly fewer opioids vs. the FNB group on postoperative day 1, according to the study.
Disclosure: The authors have no relevant financial disclosures.