ABSTRACT
Our goal was to determine by direct measurement of drain output whether intraoperative
injection of bupivacaine with epinephrine significantly reduces postoperative blood
loss in total knee arthroplasty (TKA).
The study and control groups were primary TKAs performed by 1 surgeon using a single-cemented
TKA design and a consistent postoperative protocol. The study group comprised 37 sequential
TKAs injected intraoperatively with bupivacaine and epinephrine (one-third pericapsular,
two-thirds peri-incisional). The control group included 71 sequential TKAs.
The study group had 32% (95% confidence interval, 11%-48%), or 195 mL, less drain
output (P = .006). There were no statistically significant differences in the transfusion rate
or bleeding indices. Control and study groups were comparable regarding tourniquet
times, intraoperative soft-tissue releases, preoperative anticoagulant use, and overall
postoperative complications.
Our study demonstrated a statistically significant decrease in TKA postoperative drain
output with intraoperative injection of bupivacaine with epinephrine.
