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Adequate enrollment was not reached for this study.
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The investigators plan to evaluate the length of time to discharge readiness between the groups (continuous femoral nerve blocks (cFNB) vs. liposomal bupivacaine (LB) vs. periarticular infusion cocktails (PIC) following primary total knee arthroplasty (TKA). In addition, the investigators will compare quadriceps strength recovery over time and exploratory variables between the groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| liposomal bupivacaine (LB) (Exparel) | Active Comparator | Mixture of 50 milliliters (mL) of 0.25% Bupivacaine with epinephrine, 40 mL of sterile saline and 20 mL of Exparel®. |
|
| Ropivacaine cocktail (PIC) | Active Comparator | 400 milligrams (mg) Ropivacaine, 5 mg morphine, and 0.4 mg epinephrine in 100 cc solution |
|
| continuous femoral nerve blocks (cFNB) | Active Comparator | Continuous Femoral Nerve Block- 0.25% Bupivacaine at a rate of 5 ml/hour for 48 Hours. Sciatic nerve block - 0.125% bupivacaine |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exparel | Drug | Mixture of 50 mL of 0.25% Bupivacaine with epinephrine, 40 mL of sterile saline and 20 mL of Exparel®. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to Discharge Readiness | Time to discharge readiness will be defined as the time from surgical stop to the time of the 2nd consecutive assessment where all criteria are fulfilled. | Participants will be followed for the duration of hospital stay, an average of 3 days |
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Inclusion Criteria:
Exclusion Criteria:
Opiate Tolerant (≥60mg/day oral morphine/equivalent for ≥1 week)
Neuromuscular deficit affecting the lower limbs
Known allergy or intolerance to Bupivacaine or Ropivacaine
Hepatic Disease
Renal Disease/Patients needing Dialysis
Planned unicompartmental knee replacement
Less than 90 degree of knee flexion preoperatively.
Patients who lack the capacity to consent or are unwilling to do so
At the discretion of the PI, patients who may have difficulty complying with standard of care (SOC) followup may also be excluded
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| Name | Affiliation | Role |
|---|---|---|
| Christopher Pelt, M.D. | University of Utah | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Utah Orthopaedic Center | Salt Lake City | Utah | 84108 | United States |
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| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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| Ropivacaine cocktail (PIC) | Drug | 400 mg Ropivacaine, 5 mg morphine, and 0.4 mg epinephrine in 100 cc solution |
|
| Bupivacaine | Drug | Continuous Femoral Nerve Block- 0.25% Bupivacaine at a rate of 5 ml/hour for 48 Hours. Sciatic nerve block - 0.125% bupivacaine |
|
| D000588 |
| Amines |