Anesthesia Clinical Trial
Official title:
Comparative Feasibility and Efficacy of a Five Compartment Technique Using 0.25% Bupivacaine vs a Mixture of 0.25% Bupivacaine and 1.3 % Liposomal Bupivacaine in Patients Undergoing Tka; a Single Blinded Randomized Controlled Study
Total knee and hip replacements are some of the most common orthopedic procedures that require aggressive postoperative pain management. This management helps us to improve clinical outcomes such as participation in early physical therapy, hospital discharge, and patient satisfaction. Based on the recent anatomical evidence and the investigator's knowledge of the complexity of the knee joint innervation the investigator proposes a new regional anesthesia technique that provides a complete sensory blockade and better analgesia while preserving the quadriceps strength and avoiding the potential for foot drop caused by inadvertent blockade of the common peroneal nerve.
This is an assessor-blinded randomized controlled trial evaluating the efficacy of liposomal
bupivacaine (Exparel) in patients undergoing Total Knee Arthroplasty. The primary outcome of
this study is the proportion of patients "fit to discharge" on postoperative day one.
Recently, liposomal bupivacaine (LB) (Exparel) was introduced into clinical practice, using a
lipid-based depot (DepoFoam) technology for sustained release of bupivacaine. LB (Exparel)
uses this technology to extend the delivery of bupivacaine, a local anesthetic that has been
used in clinical practice for decades for peripheral nerve block, spinal, and epidural
analgesia and anesthesia. This formulation prolongs the duration of analgesia of bupivacaine
for up to 72 hours with a single injection. The study was designed to compare two of our
current standard therapies:
1. Adductor Canal Block + Tissue Infiltration (lateral, medial and femoral compartment +
posterior capsule tissue infiltration using 0.25% bupivacaine; and
2. Adductor Canal Block + Tissue Infiltration (lateral, medial and femoral compartment +
posterior capsule tissue infiltration) using 1:1 mixture of 1.3% LB (Exparel) + 0.5%
bupivacaine HCl mixture.
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