Comparison of Selected Outcomes Associated with Two Postoperative Analgesic Approaches in Patients Undergoing Total...

Femoral nerve blocks (FNBs) and periarticular injections (PAIs) are often used for analgesia following bone and joint surgery. The purpose of this retrospective analysis was to investigate the association of analgesic technique with outcomes. All patients receiving total knee arthroplasty (TKA) at a regional medical center in 2014 were analyzed. Patients were grouped by whether they received an FNB or PAI of bupivacaine liposome injectable suspension (Exparel) for postoperative analgesia. Outcome variables of pain perception, morphine equivalents administered, length of stay, and total cost of care were compared using 2-tailed t tests. Readmission rate was examined using a 2-sample z test for proportions. One hundred forty-four patients were included in the study. This analysis demonstrated an association between receiving an FNB and less pain perception (P = .0497). Results also demonstrated a possible relationship between less opioid consumption in patients receiving a PAI of liposomal bupivacaine (P = .037). No statistical differences were found for the other variables. Receiving a FNB was preferable regarding patients' pain perception. Patients received less opioid analgesic when they received a PAI, possibly relating to the particular surgeon performing the primary TKA. Patients were 5 times likelier to require hospital readmission in the PAI group.