Lum Zachary C, Lombardi Adolph V, Hurst Jason, Morris Michael, Berend Keith
Joint Implant Surgeons, Inc., New Albany, Ohio.
J Surg Orthop Adv. 2016 Winter;25(4):222-226.
The purpose of this study was to determine if periarticular injection (PAI) with liposomal bupivacaine cocktail has a synergistic effect on pain relief with a single-injection adductor canal block in knee arthroplasty. Three hundred thirty-three knee arthroplasties were divided into three groups. Group 1 received general anesthesia (GA) and liposomal bupivacaine PAI. Group 2 received GA, peripheral nerve block (PNB), and liposomal bupivacaine PAI. Group 3 received GA, PNB, and ``plain'' ropivacaine PAI. Remaining perioperative multimodal medications and therapies were identical. There were no statistically significant differences in average narcotic use between any groups on the day of surgery, postoperative day 1, or postoperative day 2. Group 3 had the lowest postoperative nausea. Group 2 had the least pruritis. The current study failed to demonstrate a decrease in narcotic consumption with the combination of liposomal bupivacaine PAI and PNB. This study supports previous studies demonstrating that liposomal bupivacaine PAI provides similar outcomes to PNB.
本研究的目的是确定脂质体布比卡因混合液关节周围注射（PAI）与膝关节置换术中单次注射内收肌管阻滞联合使用时，对缓解疼痛是否具有协同作用。333例膝关节置换术患者被分为三组。第1组接受全身麻醉（GA）和脂质体布比卡因PAI。第2组接受GA、周围神经阻滞（PNB）和脂质体布比卡因PAI。第3组接受GA、PNB和“普通”罗哌卡因PAI。其余围手术期多模式药物治疗和疗法相同。在手术当天、术后第1天或术后第2天，任何组之间的平均麻醉药物使用量均无统计学显著差异。第3组术后恶心发生率最低。第2组瘙痒症状最轻。本研究未能证明脂质体布比卡因PAI与PNB联合使用可减少麻醉药物的消耗。本研究支持先前的研究，即脂质体布比卡因PAI与PNB的效果相似。
