ArticleJournal of orthopaedic surgery and research2024
The preventive efficacy of lipid emulsion on the occurrence of local anesthetic systemic toxicity in patients receiving local infiltration analgesia for total joint arthroplasty.
Article in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- A Phase I Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of QP002 for the Treatment of Post-Operative Pain After Tension-Free Repair of Open Unilateral Inguinal Hernia.Drug design, development and therapy · 2025Trial
- Do Adductor Canal Blocks Provide Additional Analgesic Benefit to Periarticular Injection Alone for Primary Total Knee Arthroplasty?Arthroplasty today · 2026Article
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Authors and funding
5 authors.
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Abstract
backgroundMotor-sparing local infiltration analgesia (LIA) enhances recovery after total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, LIA can induce local anesthetic systemic toxicity (LAST), sometimes necessitating rescue lipid emulsion therapy. Our institute initiated a pilot study to pretreat patients with lipid emulsion (SMOFlipid
methodsThis retrospective study enrolled 1,621 adult patients who received LIA with bupivacaine (2-3 mg/kg, maximum 300 mg) for unilateral primary THA or TKA under general anesthesia between January 2020 and April 2022. A total of 439 patients received lipid pretreatment, while 1,182 did not. Demographics, surgical and anesthesia profiles, along with LAST events affecting the neurological, cardiovascular, and respiratory systems, were compared after propensity score matching for age, sex, body mass index (BMI), and surgery type.
resultsThe incidence of severe LAST events requiring rescue lipid emulsion slightly decreased after lipid pretreatment (from 2.54 to 2.28 per 1000). Lipid pretreatment significantly reduced the incidence of bradycardia and new-onset arrhythmia (odds ratio: 0.13, adjusted p-value: 0.024) but increased postoperative opioid requirement (odds ratio: 1.71, adjusted p-value: 0.032) after Benjamini-Hochberg correction for multiplicity.
conclusionsThe efficacy of lipid pretreatment (SMOFlipid
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