University of Louisville Postoperative Pain Cocktail

The University of Louisville Postoperative Pain Cocktail is a multimodal periarticular injection (PAI) formulation developed for the management of acute pain following total knee arthroplasty (TKA). This specific analgesic mixture, studied in a Phase 4 clinical trial (NCT02143323), typically combines liposomal bupivacaine (Exparel) with a standard cocktail of bupivacaine hydrochloride (Marcaine), morphine, epinephrine, and ketorolac (Toradol). The cocktail utilizes a synergistic approach to provide both immediate and extended-release analgesia. Liposomal bupivacaine provides prolonged blockade of voltage-gated sodium channels for up to 72 hours, while morphine acts as a mu-opioid receptor agonist for regional pain control. Ketorolac provides anti-inflammatory effects through cyclooxygenase inhibition, and epinephrine acts as a local vasoconstrictor to prolong the duration of the anesthetic effect and minimize systemic absorption. This multimodal strategy aims to reduce postoperative opioid consumption and improve functional recovery in orthopedic patients.

Other names

cocktail-University of Louisville-postoperative painUofL PAI CocktailExparel-based periarticular injection cocktailUniversity of Louisville TKA Pain Cocktail