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American Society for Action on Pain

UI - 000080

AU - Pettine KA

AU - Wedel DJ

AU - Cabanela ME

AU - Weeks JL

TI - The use of epidural bupivacaine following total knee arthroplasty

AB - Pain relief and maximization of knee joint range of motion (ROM) are the two major goals in the

postoperative management of the total knee arthroplasty (TKA) patient. Epidural bupivacaine infusions have

been reported to be safe and effective for pain control in obstetric anesthesia, chronic pain management, and

postoperative pain relief. The purpose of this study was to evaluate the effect of continuous epidural

bupivacaine on postoperative pain and progressive knee ROM as well as to record the incidence of urinary

retention and other side effects or complications. Continuous epidural bupivacaine infusion was found to

provide safe, effective analgesia for TKA patients in the immediate postoperative period. Excellent pain

relief with reduced narcotic requirements was observed in the patients as compared to intramuscular narcotic

analgesia. No complications occurred and serum bupivacaine levels remained well below toxic levels. Short

term clinical orthopaedic outcome was improved, and patient, surgeon, and nurse acceptance of the

technique was excellent

SO - Orthopaedic Review 1989;18:894-901