Category: Professional Posters
Purpose: Assess the impact of Pharmacy compounded cocktail (Ketorolac 30 mg, Ropivacaine 0.5 %, Epinephrine 0.5 mg, Clonidine 0.08 mg) in Total Knee Replacement.
Methods: A retrospective chart review was conducted comparing patients who received liposomal bupivacaine (n=35) to patients receiving standard therapy (n=35), and a pharmacy compounded joint cocktail (n=35) after TKA. All groups received the standard perioperative pain management protocols and postoperative physical therapy. Statistical analysis was performed on day of surgery, post-operative day 1, and post-operative day 2. P value of < 0.05 was consider to be statistically significant. Results are presented as a multivariate analysis of treatment time and also with procedure performed for doses and pain level. The primary outcome assessed were the use of opioids, level of pain, and length of stay
Results: A pairwise comparison demonstrated that there was a statistically significant difference (p <0.05) between orthopedic cocktail (OC), liposomal bupivacaine (LB) and standard of care (SOC) Groups for minimum and maximum pain scores, total doses and milligrams morphine equivalents (MME). However no statistical significance was found when comparing between LB and SoC for minimum (p =1.0) and maximum (p =0.688) scores. Similarly, comparison between LB and SoC showed no statistically significant difference in PO dose (p =0.704) or MME dose (p =0.090). However, IV dose was found to be statistically different for this comparison group.
Conclusion: Orthopedic cocktail show superiority over LB and SoC in lowering minimum and maximum pain scores. It was also effective in lowering the total number of doses of opioid pain medications and overall MME. During our initial assessment, no significant difference was found between Exparel and SoC.