Exparel for TKR

[ethilo]

Folks:
Dovetailing off the "exparel for ISB" post, our surgeons are introducing exparel periarticular injections for our total knee pathway. They want to use the full 266mg AND have us do a single shot ACB. We are concerned about LAST. Just wondering if anyone has experience with it in the total knee pathway.

We currently do ACB catheter in pacu postop, surgeon uses some sort of joint cocktail.

---

Members don't see this ad.

 

[AdmiralChz]

Folks:
Dovetailing off the "exparel for ISB" post, our surgeons are introducing exparel periarticular injections for our total knee pathway. They want to use the full 266mg AND have us do a single shot ACB. We are concerned about LAST. Just wondering if anyone has experience with it in the total knee pathway.

We currently do ACB catheter in pacu postop, surgeon uses some sort of joint cocktail.

standard ACB with periarticular (posterior capsule) Exparel is how our best orthos do it and works fantastic - these patients are always the happiest on next day rounds. Our block is always at least 2 hours before the Exparel, haven’t had any issues.

If the patient is small < 70 kg (rare, to be fair), then we adjust down the ACB dose as well as the Exparel injected. The vast majority are > 90 kg.

 

[Urzuz]

Beyond anecdotal evidence, does anyone have any non-industry funded study that shows Exparel is better than plain bupivacaine? I still haven't read a convincing study that it is, and last time I checked pretty much all non-industry funded studies showed no clinically significant difference between the two.

Thanks