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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
James Hillman
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DOI:10.17265/2328-2150/2018.08.006
Total knee arthroplasty (TKA) can contribute to
significant pain for the patient. Continuous peripheral nerve blocks (CPNBs) have been shown to be efficacious in treating post-surgical pain. The
objective of this study is to determine the efficacy of a bupivacaine 0.2%
solution administered via CPNB plus standard of care (SOC) compared to SOC
alone. SOC for this institution includes the use of opioid analgesics,
non-opioid analgesics, regional anesthesia, and other adjuncts. The primary
outcome is the overall use of post-operative pain medication. Secondary
outcomes include the average length of stay and average pain scores. Methods: A
data surveillance system was used to retrospectively identify all patients who
underwent TKA with and without the use of CPNB. To be included, patients must
have been male or female ≥ 18 years of age who
underwent TKA from September 2016 through September 2017. And 70 patients were
included in both the CPNB and SOC groups. A retrospective chart review
determined the following data: The types and amounts of pain medications used,
the length of stay, and patient-reported pain scores. Results: There was an increase in the amount of as needed pain
medication use in the CPNB + SOC vs. SOC group
with 12.97 administrations vs. 12.67 administrations respectively. Length of
stay was increased in the CPNB + SOC vs. SOC group
with 3.65 days in the CPNB + SOC group vs. 3.5
days in the SOC group. Pain scores were increased in the CPNB + SOC group with a
patient average pain score of 4.5 vs. the SOC groups average pain score of 4.4.
Conclusions: The use of a 0.2% bupivacaine solution administered via CPNB in
addition to SOC resulted in increased utilization of as needed pain medication
administration, increased average length of stay, and increased average pain
scores when compared to SOC alone.
CPNB, pain management, TKA.
Hillman, J. 2018. “Evaluation of Continuous Peripheral Nerve Block in Total Knee Arthroplasty Post-Operative Pain Management.” Journal of Pharmacy and Pharmacology 6 (8): 760-764.