Analgesic Efficacy of Continuous Bupivacaine Infusion versus Liposomal Bupivacaine in Parasacral Ischial Plane Block After Total Knee Arthroplasty: An Open-Label, Randomized, Controlled, Non-Inferiority Study.
Xuan Pan, Peng Ye, Yawen Xie et al.
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From the abstract
Effective management of posterior knee pain following total knee arthroplasty (TKA) remains a clinical challenge. Comparative analgesic efficacy of continuous parasacral ischial plane block (CPIPB) and liposomal bupivacaine (LB) is unclear.
Reported results
A total of 100 patients were enrolled and randomly assigned to the CPIPB or LB group. Both per-protocol (n=90) and intention-to-treat (n=100) analyses confirmed non-inferiority, the upper limits of the 95% CI for the differences in cumulative NRS-AUC PACU-72h at rest (PP 18.03, ITT 16.82) and activity (PP 19.82, ITT 18.42) were strictly below the 20.7 margin.
Authors' conclusions
A single-shot PIPB with LB met the prespecified non-inferiority criterion for pain relief compared with CPIPB after TKA, while CPIPB performs better in opioid consumption and early rehabilitation parameters.