Unanticipated transient sciatic nerve deficits from intra-wound liposomal bupivacaine injection during total hip arthroplasty

Liposomal bupivacaine (Exparel®) is a novel formulation of local anesthetic used to provide extended postoperative analgesia as part of a multimodal pain control regimen in patients undergoing total joint arthroplasty. In the three total hip arthroplasty cases described, all patients exhibited a tra...

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Main Authors: Wesley H. Bronson, MD, MSB, James P. Doran, BS, James Slover, MD, Donato Perretta, MD, Richard Iorio, MD
Format: Article
Language:English
Published: Elsevier 2015-06-01
Series:Arthroplasty Today
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352344115000308
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spelling doaj-f56870ec4259442d9abfeaef8435c4952020-11-25T01:33:44ZengElsevierArthroplasty Today2352-34412015-06-0112212410.1016/j.artd.2015.05.001Unanticipated transient sciatic nerve deficits from intra-wound liposomal bupivacaine injection during total hip arthroplastyWesley H. Bronson, MD, MSBJames P. Doran, BSJames Slover, MDDonato Perretta, MDRichard Iorio, MDLiposomal bupivacaine (Exparel®) is a novel formulation of local anesthetic used to provide extended postoperative analgesia as part of a multimodal pain control regimen in patients undergoing total joint arthroplasty. In the three total hip arthroplasty cases described, all patients exhibited a transient loss of neurologic function in the sciatic nerve distribution of the operated extremity lasting between 24 and 72 h during the immediate postoperative period. Due to the nature and duration of the deficits, it was concluded that they likely occurred as a result of unintended injection of the medication in close proximity to the sciatic nerve. To the best of our knowledge, these events have yet to be reported in the current literature. We recommend orthopaedic surgeons pay special attention during infiltration of the medication at the surgical site to avoid postoperative neurological deficits.http://www.sciencedirect.com/science/article/pii/S2352344115000308ArthroplastyLiposomal bupivacaineExparelPostsurgical analgesiaPostoperative neurologic deficits
collection DOAJ
language English
format Article
sources DOAJ
author Wesley H. Bronson, MD, MSB
James P. Doran, BS
James Slover, MD
Donato Perretta, MD
Richard Iorio, MD
spellingShingle Wesley H. Bronson, MD, MSB
James P. Doran, BS
James Slover, MD
Donato Perretta, MD
Richard Iorio, MD
Unanticipated transient sciatic nerve deficits from intra-wound liposomal bupivacaine injection during total hip arthroplasty
Arthroplasty Today
Arthroplasty
Liposomal bupivacaine
Exparel
Postsurgical analgesia
Postoperative neurologic deficits
author_facet Wesley H. Bronson, MD, MSB
James P. Doran, BS
James Slover, MD
Donato Perretta, MD
Richard Iorio, MD
author_sort Wesley H. Bronson, MD, MSB
title Unanticipated transient sciatic nerve deficits from intra-wound liposomal bupivacaine injection during total hip arthroplasty
title_short Unanticipated transient sciatic nerve deficits from intra-wound liposomal bupivacaine injection during total hip arthroplasty
title_full Unanticipated transient sciatic nerve deficits from intra-wound liposomal bupivacaine injection during total hip arthroplasty
title_fullStr Unanticipated transient sciatic nerve deficits from intra-wound liposomal bupivacaine injection during total hip arthroplasty
title_full_unstemmed Unanticipated transient sciatic nerve deficits from intra-wound liposomal bupivacaine injection during total hip arthroplasty
title_sort unanticipated transient sciatic nerve deficits from intra-wound liposomal bupivacaine injection during total hip arthroplasty
publisher Elsevier
series Arthroplasty Today
issn 2352-3441
publishDate 2015-06-01
description Liposomal bupivacaine (Exparel®) is a novel formulation of local anesthetic used to provide extended postoperative analgesia as part of a multimodal pain control regimen in patients undergoing total joint arthroplasty. In the three total hip arthroplasty cases described, all patients exhibited a transient loss of neurologic function in the sciatic nerve distribution of the operated extremity lasting between 24 and 72 h during the immediate postoperative period. Due to the nature and duration of the deficits, it was concluded that they likely occurred as a result of unintended injection of the medication in close proximity to the sciatic nerve. To the best of our knowledge, these events have yet to be reported in the current literature. We recommend orthopaedic surgeons pay special attention during infiltration of the medication at the surgical site to avoid postoperative neurological deficits.
topic Arthroplasty
Liposomal bupivacaine
Exparel
Postsurgical analgesia
Postoperative neurologic deficits
url http://www.sciencedirect.com/science/article/pii/S2352344115000308
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