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levobupivacaine + morphine + ketorolac + epinephrine
- Development stage
- Unknown
- Lead developer
- University of Warwick
- Modality
- Small Molecules
- Administration
- Parenteral
01
Overview
A trial-specific periarticular multimodal analgesic infiltration used during primary total knee arthroplasty in patients with knee osteoarthritis. The locally prepared injection combines **levobupivacaine** for voltage-gated sodium-channel blockade, **morphine** for opioid analgesia, **ketorolac** for cyclooxygenase inhibition, and **epinephrine** to provide local vasoconstriction that can limit bleeding and prolong local anesthetic exposure. The University of Warwick PAKA study evaluated this periarticular cocktail against femoral nerve blockade for postoperative pain relief and functional recovery after total knee arthroplasty. ([ncbi.nlm.nih.gov](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691770/))
- Other names
- levobupivacaine + morphine + ketorolac + adrenalineperi-articular infiltration with levobupivacaine + morphine + ketorolac + adrenalineperiarticular infiltration with levobupivacaine + morphine + ketorolac + epinephrine
02
Targets
PTGS2 (Prostaglandin-Endoperoxide Synthase 2)NaV (Voltage-gated sodium channels)ADRA1A (α1A)PGHS-1 (Prostaglandin G/H Synthase 1)MOR (Mu opioid receptor)
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