The Pharmacokinetics and Effectiveness of Local LevoBupivacaine Injection on Primary Total Joint Replacement Model.

Single large dose of LevoBupivacaine had been proved good analgesic effect in total joint replacement surgery. However, the safety was not well studied. For better understanding the effect and safety of local analgesic agent, we choose LevoBupivacaine with different injection way to find out. We divide patient to three groups, for comparing the effectiveness of LevoBupivacaine, and safety of LevoBupivacaine by checking intra-blood concentration. The pre-emptive analgesics and post-operative analgesics were the same as routine protocol in other total joint replacement.

Inclusion criteria

• Primary total joint replacement, no previous open surgery on the same joint
• Age 50~80 y/o, Pre-operative diagnosis: degenerative osteoarthritis
• Pre-operative deformity: varus <15°, valgus <15°, flexion contracture <15°.
• Patients with normal heart function
• Willing to receive post-operative questionnaire and outpatient clinic follow-up

Exclusion criteria

• Allergy to Patient-Controlled Analgesia or LevoBupivacaine
• Mental or cognitive illness that couldn't well response to questionnaire
• American Society Anesthesiologist more than III degree
• Liver cirrhosis, chronic renal insufficiency, heart disease or arrhythmia, insulin-dependent diabetes mellitus, and previous narcotic abuse history.
• Not suitable for using patient-controlled analgesia pump by evaluation of anesthesiologist