Springer BD et al. – This prospective study evaluated the systemic safety profile and pharmacokinetics of full–dose intraoperative periarticular injection (PAI) liposomal bupivicaine in patients undergoing bilateral simultaneous TKA. Full–dose PAI with liposomal bupivicaine was safe with systemic bupivicaine levels well below reported cardiac and neurotoxic levels.

Methods

• Blood samples were collected from 15 patients at predefined intervals until discharge and no exogenous bupivicaine was administered.
• Pharmacokinetic evaluations were subsequently performed and compared with bupivicaine toxicity levels.
• Adverse events related to anesthetic toxicity (cardiac and neurologic) were monitored in these patients.

Results

• Mean peak level (Cmax) was 0.8 µg/mL.
• All patients were well below the reported systemic cardiac and toxicity levels of 2 to 4 µg/mL.
• None of the patients reported cardiac and neurotoxic events.