Your browser doesn't support javascript.
loading
A single center descriptive study of local anesthetic dose in knee arthroplasty: Was there evidence of local anesthetic systemic toxicity?
Douglas, Rachel N; Niesen, Adam D; Johnson, Rebecca L; Olsen, David A; Taunton, Michael J; Portner, Erica R; Acker, Christopher T; Hanson, Andrew C; Kopp, Sandra L.
Afiliación
  • Douglas RN; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Douglas.Rachel@mayo.edu.
  • Niesen AD; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Niesen.Adam@mayo.edu.
  • Johnson RL; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Johnson.Rebecca1@mayo.edu.
  • Olsen DA; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Olsen.David1@mayo.edu.
  • Taunton MJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Taunton.Michael@mayo.edu.
  • Portner ER; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Portner.Erica@mayo.edu.
  • Acker CT; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Acker.Christopher@mayo.edu.
  • Hanson AC; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Andrew.Hanson@mayo.edu.
  • Kopp SL; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Kopp.Sandra@mayo.edu.
J Clin Anesth ; 97: 111534, 2024 Oct.
Article en En | MEDLINE | ID: mdl-38943851
ABSTRACT
STUDY

OBJECTIVE:

Describe dosing of local anesthetic when both a periarticular injection (PAI) and peripheral nerve block (PNB) are utilized for knee arthroplasty analgesia, and compare the dosing of local to suggested maximum dosing, and look for evidence of local anesthetic systemic toxicity (LAST).

DESIGN:

A single center retrospective cohort study between May 2018 and November 2022.

SETTING:

A major academic hospital. PATIENTS Patients who had both a PAI and PNB while undergoing primary, revision, total, partial, unilateral, or bilateral knee arthroplasty.

INTERVENTIONS:

None. MEASUREMENTS Calculate the dose of local anesthetic given via PAI, PNB, and both routes combined as based on lean body weight and compare that to the suggested maximum dosing. Look for medications, clinical interventions, and critical event notes suggestive of a LAST event. MAIN

RESULTS:

There were 4527 knee arthroplasties where both a PAI and PNB were performed during the study period. When combining PAI and PNB doses, >75% of patients received more than the suggested maximum dose of 3 mg/kg lean body weight. The median local anesthetic dosing over the study period, 4.4 mg/kg (IQR 3.5,5.9), was 147% of the suggested maximum dose (IQR 117,197). There was no conclusive evidence of LAST among any of the patients in the study.

CONCLUSIONS:

Over the course of our study, we had 4527 knee arthroplasties with a median PAI and PNB local anesthetic dose that was 147% of the suggested maximum without any clear clinical evidence of a LAST event.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Anestésicos Locales / Bloqueo Nervioso Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Anestésicos Locales / Bloqueo Nervioso Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos