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bupivacaine + adrenaline + methylprednisolone + cefazoline
- Development stage
- Unknown
- Lead developer
- Turgutlu State Hospital
- Modality
- Small Molecules
- Administration
- Periarticular Infiltration
01
Overview
A multimodal periarticular infiltration (PAI) cocktail used for postoperative pain management, specifically in patients undergoing total knee arthroplasty (TKA). This combination, studied by Turgutlu State Hospital, consists of the local anesthetic bupivacaine, the vasoconstrictor adrenaline (epinephrine), the corticosteroid methylprednisolone, and the antibiotic cefazoline. Bupivacaine provides regional analgesia by blocking voltage-gated sodium channels, while adrenaline prolongs its effect through local vasoconstriction mediated by alpha- and beta-adrenergic receptors. Methylprednisolone acts as an anti-inflammatory agent via glucocorticoid receptor activation to further reduce pain and swelling, and cefazoline is included for surgical site infection prophylaxis by inhibiting bacterial cell wall synthesis. The cocktail is typically administered by the surgeon into the knee capsule quadrants during the procedure.
- Other names
- PAI cocktailPeriarticular Infiltration cocktail
02
Targets
GR (Glucocorticoid receptor)PBP (Penicillin-binding protein family)ADRA1 (Alpha-1 adrenergic receptor family)ADRB1 (β1)NaV (Voltage-gated sodium channels)
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