Liposomal Bupivacaine Versus Standard Bupivacaine Plus Dexamethasone in Quadriceps Sparing Femoral Nerve Block and Wound Infiltration for Total Knee Arthroplasty

Prospective, Randomized, Double-Blinded, Allocation Concealed Study Comparing the Efficacy of Liposomal Bupivacaine Over Standard Bupivacaine Plus Dexamethasone in Quadriceps Sparing Femoral Nerve Block and Wound Infiltration for Primary Total Knee Arthroplasty

The purpose of this study is to compare the efficacy and duration of pain relief after total knee arthroplasty provided by a single injection of liposomal bupivacaine (EXPAREL®) versus standard bupivacaine with an adjuvant, dexamethasone when administered as a quadriceps sparing femoral nerve block and periarticular injection. It is hypothesized that liposomal bupivacaine is superior to standard bupivacaine with dexamethasone and will decrease time to discharge readiness.

Inclusion Criteria:

• Adult patients of American Society of Anesthesiologist (ASA) I-III physical class with a pre-operative diagnosis of primary osteoarthritis scheduled for elective primary total knee arthroplasty.
• Patients must be living independently at home prior to undergoing primary total knee arthroplasty with intention of discharge directly to home after hospitalization

Exclusion Criteria:

• Subjects will not be eligible for this trial if they have a history of allergy to a local anesthetic
• Known peripheral neuropathy
• Known connective tissue or immunological disorders
• Stroke or other known central nervous system disorders
• Renal dysfunction
• Hepatic dysfunction
• Cardiac dysfunction other than hypertension
• Pregnant subjects
• Immunosuppression
• Human immunodeficiency virus (HIV)
• Alcohol or drug abuse
• Chronic pain or opioid dependence
• Coagulopathy or those unable to comply with study requirements.