DEVICE SAFETY: Chondrolysis linked to intra-articular infusions
Joan Ferlo Todd MS, BSN, RN

$3.95
Nursing2014
June 2010 
Volume 40  Number 6
Pages 18 - 19
 
  PDF Version Available!

ABSTRACT
AFTER LEFT SHOULDER arthroscopy, an elastomeric infusion device was used to deliver a continuous infusion (over about 48 hours) of the local anesthetic bupivacaine directly into the patient's intra-articular space for postoperative pain control. Approximately 5 months following the infusion, the patient developed pain, stiffness, and loss of motion in the left glenohumeral (shoulder) joint.Postarthroscopic glenohumeral chondrolysis (PAGCL), which is necrosis and destruction of articular cartilage, was subsequently diagnosed. The patient required a total shoulder arthroplasty, according to a report sent to the FDA.The FDA has received approximately 35 reports of chondrolysis in patients who received continuous intra-articular infusions of local anesthetics with elastomeric infusion devices (often called pain pumps) for postoperative pain management. (See A closer look at elastomeric infusion devices.) The local anesthetics involved include bupivacaine, chloroprocaine, lidocaine, mepivacaine, procaine, and ropivacaine with and without epinephrine. Chondrolysis, a severe, life-altering complication, is usually irreversible. (For more details, see What's chondrolysis?)It isn't known what factor or combination of factors contributed to the development of chondrolysis in these cases. The infused local anesthetic drug, the device materials, or other sources may have contributed.Before 2000, the reported incidence of chondrolysis was low. Reports of PAGCL began to appear more frequently as surgeons began to use newer devices, such as lasers and thermal devices, and newer techniques, including intra-articular injection of dye and continuous postoperative infusion of anesthetics into the glenohumeral joint.1-3In general, elastomeric infusion devices are safe when used properly. The FDA has approved them for the perioperative and postoperative infusion of local anesthetics and opioids for pain management and regional anesthesia via the I.V., I.M., subcutaneous, perineural,

Purchase Now !

To purchase this item, follow the instructions below. If you’re not already logged in, be sure to enter your login information below to ensure that your item is saved to your File Drawer after you purchase it.

Not a member? Join now for Free!


Cost:$3.95
1) If you're not already logged in, enter your information below to save this item in your File Drawer for future viewing.

User name:


Password


Forgot your user name or password?
2)  If you have a coupon or promotional code, enter it
here.(If not, just click Continue.


Digital Coupon: (optional)

3)  Click Continue to go to the next screen, where
you'll enter your payment details.






jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles Recommended Nursing Articles

Dogs as Pets, Visitors, Therapists and Assistants
Home Healthcare Nurse, November/December 2014
Free access will expire on January 5, 2015.


Tracheostomy Care
Nursing2014 Critical Care, November 2014
Free access will expire on December 22, 2014.


Effective management of ARDS
The Nurse Practitioner, 13December 2014
Free access will expire on December 22, 2014.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events