Continuous infusion of bupivacaine following total knee arthroplasty: a randomized control trial pilot study.

Dale Williams, Danielle Petruccelli, James Paul, Liz Piccirillo, Mitch Winemaker, Justin de Beer

Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada.

The Journal of arthroplasty 2013 Mar

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An RCT pilot-study was conducted to assess efficacy of a 48-h continuous local infiltration of intra-articular bupivacaine (0.5% at 2 cc/h) versus placebo (0.5% saline at 2 cc/h) in decreasing PCA morphine consumption following TKA. Secondary outcomes included 48-h VAS pain, opioid side effects, length of stay, and knee function scores up to 1-year postoperatively. Of 67 randomized patients, 49 completed the trial including 24 bupivacaine, and 25 placebo patients. Mean 48-h PCA morphine consumption did not differ significantly between treatment (39 mg ± 27.1) and placebo groups (53 mg ± 30.4) (P = .137). The intervention did not improve pain scores, or any other outcome studied. Given study results we would conclude that analgesia outcomes with a multimodal analgesia regimen are not significantly improved by adding 48 h of 0.5% bupivacaine infiltration at 2 cc/h. Copyright © 2013 Elsevier Inc. All rights reserved.

Citation

Dale Williams, Danielle Petruccelli, James Paul, Liz Piccirillo, Mitch Winemaker, Justin de Beer. Continuous infusion of bupivacaine following total knee arthroplasty: a randomized control trial pilot study. The Journal of arthroplasty. 2013 Mar;28(3):479-84