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Liposomal Bupivacaine Versus Continuous Popliteal Sciatic Nerve Block in Total Ankle Arthroplasty.

Publication ,  Journal Article
Mulligan, RP; Morash, JG; DeOrio, JK; Parekh, SG
Published in: Foot Ankle Int
November 2017

BACKGROUND: Liposomal bupivacaine (LB) is widely used in joint arthroplasty, but there is little reported on the use of LB in foot and ankle surgery. Continuous popliteal sciatic nerve block (CPSNB) is more commonly used for major foot and ankle reconstructions. The purpose of this study was to compare use of intraoperative LB injection to CPSNB as a regional anesthetic for total ankle arthroplasty (TAA), with attention to postoperative pain scores, narcotic use, and complications. METHODS: Retrospective review of TAA patients of 2 fellowship-trained orthopedic foot and ankle surgeons was performed. Patients received either preoperative single-shot popliteal sciatic nerve block with 0.2% ropivacaine followed by intraoperative injection of LB or preoperative CPSNB alone. Outcomes examined were visual analog scale (VAS) pain score at 8 hours, 24 hours, 1 week, and 3 weeks following surgery; need for opioid pain medication refill; physician office notification for pain issues or other adverse events; and complications within the first 90 days following surgery. Standard statistical analysis was performed, and P < .05 was considered significant. Seventy-five patients were identified who underwent TAA and met inclusion criteria. Forty-one received LB, and 34 received CPSNB. RESULTS: No statistical difference was seen between groups with regard to complications, emergency department visits, readmissions, reoperations, VAS pain score at any time point, physician office contacts, and narcotic refills. Sixteen of 41 (39%) LB patients had narcotic refills, versus 12 of 34 (35%) CPSNB patients ( P = .81). Two of 41 (5%) LB patients had a complication postoperatively, versus 4 of 34 (12%) CPSNB patients. There were no complications specific to the anesthetic used in either group. CONCLUSION: This is the first study evaluating the use of LB for total ankle arthroplasty. Liposomal bupivacaine was safe and effective as an option for regional anesthetic and postoperative pain control, with comparable results to CPSNB. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Duke Scholars

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

November 2017

Volume

38

Issue

11

Start / End Page

1222 / 1228

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Sciatic Nerve
  • Risk Assessment
  • Retrospective Studies
  • Pain, Postoperative
  • Pain Measurement
  • Osteoarthritis
  • Orthopedics
  • Nerve Block
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mulligan, R. P., Morash, J. G., DeOrio, J. K., & Parekh, S. G. (2017). Liposomal Bupivacaine Versus Continuous Popliteal Sciatic Nerve Block in Total Ankle Arthroplasty. Foot Ankle Int, 38(11), 1222–1228. https://doi.org/10.1177/1071100717722366
Mulligan, Ryan P., Joel G. Morash, James K. DeOrio, and Selene G. Parekh. “Liposomal Bupivacaine Versus Continuous Popliteal Sciatic Nerve Block in Total Ankle Arthroplasty.Foot Ankle Int 38, no. 11 (November 2017): 1222–28. https://doi.org/10.1177/1071100717722366.
Mulligan RP, Morash JG, DeOrio JK, Parekh SG. Liposomal Bupivacaine Versus Continuous Popliteal Sciatic Nerve Block in Total Ankle Arthroplasty. Foot Ankle Int. 2017 Nov;38(11):1222–8.
Mulligan, Ryan P., et al. “Liposomal Bupivacaine Versus Continuous Popliteal Sciatic Nerve Block in Total Ankle Arthroplasty.Foot Ankle Int, vol. 38, no. 11, Nov. 2017, pp. 1222–28. Pubmed, doi:10.1177/1071100717722366.
Mulligan RP, Morash JG, DeOrio JK, Parekh SG. Liposomal Bupivacaine Versus Continuous Popliteal Sciatic Nerve Block in Total Ankle Arthroplasty. Foot Ankle Int. 2017 Nov;38(11):1222–1228.
Journal cover image

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

November 2017

Volume

38

Issue

11

Start / End Page

1222 / 1228

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Sciatic Nerve
  • Risk Assessment
  • Retrospective Studies
  • Pain, Postoperative
  • Pain Measurement
  • Osteoarthritis
  • Orthopedics
  • Nerve Block