4-Drug Nerve Block versus Plain Local Anesthetic for Knee and Hip Arthroplasty Analgesia in Veterans
Abstract
For joint replacement, single-injection nerve blocks with local anesthetics are simple to perform, but only provide 12-16 hours of pain relief that includes muscle weakness. This study evaluated an innovative 36-hour single-injection nerve block that combined a low-concentration local anesthetic with other pain relievers injected near the nerve. In veterans undergoing total hip or knee replacement, we compared single-injection nerve blocks with the plain local anesthetic bupivacaine against a 4-drug combination (including bupivacaine) in veterans undergoing hip or knee replacement surgery. The other 3 drugs were buprenorphine-clonidine-dexamethasone (BCD). Based on these two treatments, the goals are to determine differing effects on (1) pain; (2) physical function; (3) discharge plans after hospital care; (4) satisfaction with treatment and emotional response; and (5) symptoms and adverse events. These outcome domains were measured using both validated and innovative methods. Preoperative baseline survey data were collected, and patient-follow-up took place during days 1-4, and at 2 and 6 weeks after surgery. This research took five years. We found that the 36-hour single-injection 4-drug nerve block had likely potential immediate military relevance ,by reducing or eliminating the complexity involved with inserting nerve block catheters in injured soldiers in or near the battlefield before lengthy transport to definitive medical care.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 01, 2021
- Accession Number
- AD1212587
Entities
People
- Brian A. Williams
Organizations
- University of Pittsburgh