Liposomal Bupivacaine versus Bupivacaine Hydrochloride Plus Dexamethasone for Combined Adductor Canal and iPACK Blocks in Total Knee Arthroplasty: A Randomized Controlled Trial.
Pusheng Ren, Liang Zeng, Li Zhao et al.
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In 30 seconds
This randomized controlled trial compared postoperative analgesia and quadriceps recovery between liposomal bupivacaine and bupivacaine hydrochloride plus dexamethasone in 60 patients undergoing total knee arthroplasty. The study found that at 24 hours, resting VAS scores were significantly lower in the liposomal bupivacaine group (2.4±0.8) compared to the dexamethasone group (2.9±1.1), with a mean difference of -0.52 points (P=0.040).
Key findings
- Resting VAS scores at 24 hours were 2.4±0.8 in the BL group versus 2.9±1.1 in the Dex group (P=0.040).
- Quadriceps strength favored the BL group at 12 hours post-surgery.
- Cumulative PCIA volume at 48 hours was significantly lower in the BL group (99.75 mL) compared to the Dex group (100.00 mL, P<0.001).
- Rescue analgesia was more frequent in the Dex group (RR=2.40, P=0.024).
Why it matters
The findings suggest that liposomal bupivacaine may provide superior early postoperative pain control and quadriceps strength recovery compared to traditional bupivacaine plus dexamethasone, which could influence analgesic strategies in total knee arthroplasty.