Anesthesia selection is a critical decision that influences early postoperative outcomes after TKA. Total knee arthroplasty (TKA) is one of the most commonly performed procedures in the US and the demand for this surgery is expected to increase with an estimated 3.48 million TKAs performed annually by 2030. Based on these results, mepivacaine appears to be a viable alternative to bupivacaine for use in TKA rapid recovery protocols. In patients undergoing TKA with a spinal anesthesia, after adjusting for potentially confounding factors using propensity score matching, the use of mepivacaine was associated with shorter length of stay, less overall OMME requirements, and increased likelihood of home discharge, with no increase in complication rates. No differences in rates of nausea, urinary retention, or 30-day readmissions were observed between the groups. After propensity score matching, patients who received bupivacaine experienced longer lengths of stay, received more oral morphine milligram equivalents (OMMEs), and were less likely to be discharged home. Of the 553 patients, 102 received mepivacaine, and 451 received bupivacaine. Univariate comparisons before and after propensity score matching were used to compare outcomes for TKA patients receiving mepivacaine with those who did not. Patients were divided by their receipt of mepivacaine or bupivacaine. Materials and Methods:Ī retrospective review of 553 unilateral primary TKA patients who received spinal anesthesia was conducted. We sought to compare outcomes between spinal anesthetics in our high-volume joint institution. It does not store any personal data.Previous literature indicates that mepivacaine used for spinal anesthesia may lead to reduced recovery time and urinary retention compared to bupivacaine in patients undergoing total knee arthroplasty (TKA). The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. The cookie is used to store the user consent for the cookies in the category "Performance". This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. The cookies is used to store the user consent for the cookies in the category "Necessary". The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". The cookie is used to store the user consent for the cookies in the category "Analytics". These cookies ensure basic functionalities and security features of the website, anonymously. Necessary cookies are absolutely essential for the website to function properly. Watch this webinar to learn how using wireless ultrasound can help you perform quicker, safer procedures with less guesswork, and in many cases less anesthetic for more effective blocks. It should help anyone’s confidence in what they’re doing to be able to see what they’re doing.” Hickman shares the advantages of wireless ultrasound for regional anesthesiology, “It improves your speed of being able to do the block, and it actually improves the duration of block because you’re getting more local around the target nerve versus doing it blind where you really don’t see it. Hickman shares his techniques for using high-resolution wireless ultrasound to perform 3 different pre-op blocks quickly, accurately, and efficiently to deliver maximum pain management for ACL repair surgery.ĭr. Depending on the surgery being performed and rehabilitation that follows, only select nerves need to be blocked, while and others avoided. Innervation of the knee joint and surrounding tissues is complex. High-resolution ultrasound has proven invaluable in the precision and accuracy required to perform these blocks. An effective adductor canal block can actually facilitate post-operative rehab. Anesthesiologists work “behind the scenes” to ensure patients have minimal pain following knee surgeries, and at the same time ensuring sensory and motor function of the leg and foot is preserved. With an aging population, knee surgeries are now one of the most frequently performed procedures. Hickman as he shares video of an actual patient procedure, demonstrating how wireless ultrasound ensures excellent regional blocks for pain control immediately post-operatively and longer term if needed. Learn ultrasound-guided injection techniques from the expert! Watch Dr.
0 Comments
Leave a Reply. |