The purpose of this study was to investigate the effect of bupivacaine liposomes on postoperative pain in TKA ( total knee replacement ) patients.The main questions answered are:
1. Is bupivacaine liposomes superior to bupivacaine in femoral triangle block or adductor block in terms of 72 hours opioid consumption after knee replacement 2. Which block method(Femoral triangle block or adductor block) combined with bupivacaine liposome was more effective in alleviating pain score and 72 hours opioid consumption after total knee surgery.
investigators will investigate the effect of bupivacaine liposomes combined with bupivacaine and pure bupivacaine on pain after total knee arthroplasty using femoral triangle block or adductor block.
Participants will:
1. Receive liposomal bupivacaine or bupivacaine as a regional anesthetic for femoral triangle block or adductor block under ultrasound guidance. 2. Undergo total knee replacement surgery under spinal anesthesia. 3. Follow-up within 72 hours after surgery , opioid consumption, NRS score, PCA（Patient controlled analgesia，PCA） data, first postoperative remedial analgesia time, quadriceps muscle strength and complications were recorded
Patients with ASAI-ⅲ
Receive a unilateral initial TKA
Age 18-80 years old -
Bilateral TKA surgery
TKA revision surgery
Contraindications for nerve block and intraspinal anesthesia
Allergies to local anesthetics
Factorial
Bupivacaine liposome
DrugSubjects receive liposomal bupivacaine as a regional anesthetic for femoral triangle block or adductor block under ultrasound guidance.
Nerve block mode : adductor block
Procedure/SurgerySubjects receive liposomal bupivacaine or bupivacaine as a regional anesthetic for adductor block under ultrasound guidance.
Bupivacaine
DrugSubjects receive bupivacaine as a regional anesthetic for femoral triangle block or adductor block under ultrasound guidance.
Nerve block mode: femoral triangle block
Procedure/SurgerySubjects receive liposomal bupivacaine or bupivacaine as a regional anesthetic for femoral triangle block under ultrasound guidance.
Opioid consumption 72 hours after surgery
This primary outcome entails tracking and assessing the total opioid consumption by participants following total knee replacement surgery. The evaluation includes quantifying the amount of opioids prescribed and consumed by participants for pain management post-surgery. Opioid medications administered will be converted to morphine equivalents based on established conversion ratios. By analyzing overall opioid consumption, the study aims to evaluate the efficacy of the interventions in managing postoperative pain.
Pain intensity
Pain intensity will be assessed using the Numerical Rating Scale (NRS), a 0-10 scale where 0 represents no pain and 10 represents the worst imaginable pain
Time to First Rescue Analgesic
Time to first rescue analgesic will be recorded as the interval from the end of the surgery to the administration of the first dose of rescue analgesic medication postoperatively.
Total opioid dosage and PCA times
The evaluation includes quantifying the amount of opioids prescribed and consumed PCA times by participants for pain management post-surgery.
Quadriceps muscle strength
The quadriceps muscle strength is measured with a hand-held dynamometer
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