Liposomal Bupivacaine for Post Operative Pain After Knee Replacement Surgery

This is a prospective, randomized, active controlled study in patients undergoing total knee
replacement. The objective of this study is to compare the efficacy of Liposome Bupivacaine,
in managing postoperative pain, to standard of care CFNB. Following informed consent,
patients will be randomized to one of two groups, Liposome Bupivacaine or active control,
CFNB group.

266 mg Liposome Bupivacaine plus Bupivicaine HCL (150mg) will be administered via local joint
infiltration around the knee joint prior to wound closure. In the control group a CFNB will
be placed for 48hrs prior to surgery. Outcomes measured included pain at rest, movement and
quadriceps muscle strength on the first and second postoperative day.

It is hypothesized that Liposome Bupivacaine will provide effective pain control and improved
preservation of quadriceps muscle strength, in comparison to CFNB.

Inclusion Criteria:

- ASA Status I-III

- Scheduled to undergo primary unilateral total knee arthroplasty

Exclusion Criteria:

- Patients who are pregnant or nursing

- Alcohol or narcotic dependence within the last 2 years

- Condition requiring regular use of analgesia that may confound post surgical
assessments as determined by principle investigator

- BMI > 40kg/m2

- Contraindication to acetaminophen, morphine, oxycodone, ketorolac, epinephrine, or
pathological conditions potentially aggravated by epinephrine

- Allergies to amide-type local anesthetics

- Any disease condition or lab result that could complicate a patients postoperative
recovery

- History of hypotension

- Abnormal liver, renal or cardiac function

- Other physical, mental or medical conditions that, in the opinion of the investigator,
make study participation inadvisable.