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Does the use of periarticular Exparel in total knee arthroplasty prove to more effectively manage post operative pain control than another local analgesic, Ropivacaine, when both are used as part of a multimodal pain management approach?
The investigators hypothesize that Exparel, a bupivacaine liposomal injectable suspension, will improve total knee arthroplasty postoperative pain with significant improvement of early function outcomes.
The investigators use a double blind, controlled, randomized study to examine the effectiveness of periarticular Exparel in total knee arthroplasty postoperative pain control as well as effect on early mobilization and length of hospital stay when compared to another local analgesic (Ropivacaine) when both are used as part of a multimodal pain management approach.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pain Cocktail with Ropivacaine | Active Comparator | patients given the standard intra-articular "pain cocktail" injection, consisting of ropivacaine, ketorolac, morphine, and epinephrine mixed with saline into a 100cc preparation. given in one single dose |
|
| Pain Cocktail with Exparel | Experimental | patients given a similar intra-articular injection consisting of bupivacaine, ketorolac, morphine, and epinephrine mixed with saline into a 80cc preparation as well as an injection of Exparel, 20cc of 1.3% Exparel, to total 100cc. given in one single dose |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pain Cocktail with Exparel | Drug | pain cocktail: bupivacaine, ketorolac, morphine, and epinephrine mixed with saline into a 80cc preparation as well as an injection of Exparel (bupivacaine liposome injectable suspension), 20cc of 1.3% Exparel, to total 100cc. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative opioid consumption | oral and intravenous narcotic consumption is recorded during hospital stay | immediately post-operatively through hospital stay |
| Measure | Description | Time Frame |
|---|---|---|
| Hours to ambulate 100 feet | immediately post-operatively through hospital stay | |
| Length of hospital stay (hours) | Number of hours the patient stays at the hospital following operation | immediately post-operatively through hospital stay |
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Inclusion Criteria:
Exclusion Criteria:
> 60 mg oral morphine/day > 25μg transdermal fentanyl/hour > 30 mg oral oxycodone/day > 8 mg oral hydromorphone/day > 25 mg oral oxymorphone/day
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| Name | Affiliation | Role |
|---|---|---|
| Olayinka Warritay, MD | DeClaire LaMacchia Orthopaedic Institute | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28478185 | Derived | DeClaire JH, Aiello PM, Warritay OK, Freeman DC. Effectiveness of Bupivacaine Liposome Injectable Suspension for Postoperative Pain Control in Total Knee Arthroplasty: A Prospective, Randomized, Double Blind, Controlled Study. J Arthroplasty. 2017 Sep;32(9S):S268-S271. doi: 10.1016/j.arth.2017.03.062. Epub 2017 Apr 6. |
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| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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|
| Pain Cocktail with Ropivacaine | Drug | pain cocktail: ropivacaine, ketorolac, morphine, and epinephrine mixed with saline into a 100cc preparation. |
|
| Visual Analog Pain Score | day 1 and day 2 after operation, 3 months, 6 months, and 1 year operatively |
| Knee Society Score | 3 months, 6 months, 1 year postoperatively |
| D010468 |
| Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D000588 |
| Amines |