💬In plain words
What the trial is, and whether it could suit you
Total knee arthroplasty is a commonly performed orthopaedic surgery for the treatment of end-stage osteoarthritis when conservative management becomes ineffective. TKA is associated with significant acute postoperative pain and many patients experience severe postoperative pain despite the use of multimodal analgesia. Poor acute postoperative pain control impacts rehabilitation, prolongs recovery and increases opioid consumption and chronic post-surgical pain.
Liposomal bupivacaine (Exparel, Pacira Pharmaceuticals Inc, Parsippany, New Jersey, USA) is a multivesicular formulation of bupivacaine that prolongs drug release and can extend the duration of analgesia. The adductor canal block (ACB) has been shown to reduce pain intensity and opioid consumption after total knee arthroplasty. The use of liposomal bupivacaine in the adductor canal block has recently been FDA-approved. However, th
Sign in to get the eligibility rules as simple questions to take to your doctor.
📋 Eligibility rules (as published)
Inclusion Criteria:
* ASA I-III
* Age 18-80 years old
* Scheduled for elective primary unilateral total knee arthroplasty (TKA) with robotic surgery
* Able to speak and understand Cantonese or Mandarin or English
* Able to provide informed oral and written consent
Exclusion Criteria:
* Revision TKA
* Single-stage bilateral TKA
* Complex primary TKA requiring use of stem/augment/constrained liner
* Surgeries with significant intraoperative complications which may alter rehabilitation protocol eg collateral ligament injury, fracture requiring fixation
* Known allergy to opioids, local anaesthetic drugs, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDS) including COX-2 inhibitors
* History of chronic pain other than chronic knee pain
* History of immunosuppression
* Chronic use of glucocorticoids
* Chronic opioid use (morphine, fentanyl, hydromorphone, ketobemidone, methadone, nicomorphine, oxycodone, or meperidine)
* History of congestive heart failure (NYHA 2)
* Alcohol or drug abuse
* Impaired renal function (defined as effective glomerular filtration rate \< 30ml/min/1.73m2
* Impaired liver function (defined as plasma bilirubin over 34mol/L; international normalized ratio \[INR\] \>= 1.7, alanine aminotransferase \[ALT\] over 100U/L, aspartate aminotransferase \[AST\] over 100U/L)
* Coagulopathy (platelet count \<100,000/ml and/or INR \>= 1.5) or the use of anticoagulants (not including aspirin) that precludes the use of adductor canal blocks
* Pre-existing neurological or muscular disorders
* Psychiatric illness
* Impaired mental state
* Pregnancy
* Local infection
* On immunosuppressants
* High body mass index (BMI) (\>=40)
* Patient refusal for regional nerve blocks or to conduct clinical trial
💊
What it tests
- 0.5% standard bupivacaine only
- 1.33% liposomal bupivacaine with 0.5% standard bupivacaine
- 1.33% liposomal bupivacaine only
The University of Hong Kong
Hong Kong, Hong Kong
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
HealthTeky