CORR Insights^®: No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

Excerpt

The randomized controlled trial by Barrington and colleagues raises new questions about the utility of using liposomal bupivacaine-based periarticular injection (PAI) (Exparel; Pacira Pharmaceuticals, Parsippany, NJ, USA) to improve pain management after TKA, as the only benefit was a decrease in the postoperative itching from 38% to 15% when intrathecal morphine was not injected. This randomized controlled trial also shows that interventions such as intraarticular addition of extended-release liposomal bupivacaine or intrathecal morphine do not clearly improve pain profiles or opioid requirements after TKA surgery when compared to a PAI with standard bupivacaine and associated with multimodal analgesia including acetaminophen, Celebrex (G.D. Searle LLC Division of Pfizer Inc, New York, NY, USA), OxyContin (Purdue Pharma LP, Stamford, CT, USA), and Decadron (Merck & Co Inc, Kenilworth, NJ, USA). This raises the real question: Is there still room for liposomal bupivacaine in TKA surgery? …