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Liposomal bupivacaine injectable suspension (Exparel), manufactured by Pacira Pharmaceuticals, is an FDA-approved, long-lasting nonopioid analgesic that is indicated for single-dose infiltration in adults to produce postsurgical local analgesia. Exparel's extended bioavailability allows for 48 hours of pain control. Periarticular infiltration of liposomal bupivacaine has been safely and effectively used for total knee arthroplasty as an alternative to FNBs, avoiding transient quadriceps weakness and potential in-hospital falls. Recently Exparel has been FDA approved for interscalene brachial plexus nerve block to produce postsurgical regional analgesia for upper extremity/shoulder procedures. It is not yet approved for peripheral nerve blocks of the lower extremity.
No study to date, to our knowledge, has evaluated the efficacy of single-dose adductor canal blockade with Exparel compared to femoral nerve catheter with bupivacaine. We pose that Exparel used for an adductor canal block can offer the benefit of a single-dose injection with extended pain control without the burden of an indwelling catheter and to avoid adverse events of femoral nerve blockade related to quadriceps weakness and dysesthesias.
The purpose of this study is to determine whether adductor canal blockade with liposomal bupivacaine (Exparel) is a safe and effective alternative to femoral nerve catheters for post-operative pain control for patients undergoing ACL reconstruction.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre-operative femoral nerve catheter | Active Comparator | participants undergoing ACL reconstruction surgery will receive a femoral prior to their surgery |
|
| Pre-operative adductor canal block with liposomal bupivacaine | Active Comparator | participants undergoing ACL reconstruction surgery will receive a nerve block using liposomal Bupivacaine (Exparel) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| OxyCODONE 5 mg Oral Tablet | Drug | Participants will receive 20 OxyCODONE 5 mg Oral Tablet post surgery for pain control |
|
| Measure | Description | Time Frame |
|---|---|---|
| Patient satisfaction | Participant will record Patient Satisfaction through Visual Analog Scale for pain | 8 weeks |
| Post operative pain management | Participant will receive 20 5mg tablets of Oxycodone and will record opioid consumption through post operative instruction sheets from pain control regiments. | 8 weeks |
| Post operative pain management | Participant will record quadriceps function tests | 8 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rothman Orthopaedic Institute | Philadelphia | Pennsylvania | 19107 | United States |
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| Naproxen 500 Mg | Drug | Participant will receive Naproxen 500 Mg post surgery for pain control |
|
| Tylenol Pill | Drug | Participants will be instructed to take up to 1000mg of Tylenol by mouth for pain control |
|
| Liposomal bupivacaine | Drug | Participants will receive pre-operative adductor canal block with liposomal bupivacaine (Exparel) |
|
|
| Femoral Nerve Catheter | Procedure | Participants will receive pre-operative femoral nerve catheter |
|
|
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D010098 | Oxycodone |
| D013607 | Tablets |
| D009288 | Naproxen |
| D000082 | Acetaminophen |
| ID | Term |
|---|---|
| D003061 | Codeine |
| D009022 | Morphine Derivatives |
| D009019 | Morphinans |
| D053610 | Opiate Alkaloids |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D006572 | Heterocyclic Compounds, Bridged-Ring |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D010616 | Phenanthrenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D011083 | Polycyclic Compounds |
| D004304 | Dosage Forms |
| D004364 | Pharmaceutical Preparations |
| D009280 | Naphthaleneacetic Acids |
| D009281 | Naphthalenes |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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