{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:18:41Z","timestamp":1790083121389,"version":"4.0.1"},"reference-count":35,"publisher":"Elsevier BV","issue":"9","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroplastyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Arthroplasty"],"published-print":{"date-parts":[[2020,9]]},"DOI":"10.1016\/j.arth.2020.04.042","type":"journal-article","created":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T20:38:40Z","timestamp":1587415120000},"page":"2439-2443","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Impact of Epinephrine in the Periarticular Injection Cocktail using Ropivacaine for Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Comparison Study"],"prefix":"10.1016","volume":"35","author":[{"given":"Dong Yi","family":"Kong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Han","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Rak","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Il","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choong H.","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.arth.2020.04.042_bib1","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1053\/j.trap.2008.09.007","article-title":"The role of regional anesthesia in patient outcome: orthopedic surgery","volume":"12","author":"Borgeat","year":"2008","journal-title":"Tech Reg Anesth Pain Manag"},{"key":"10.1016\/j.arth.2020.04.042_bib2","doi-asserted-by":"crossref","first-page":"117","DOI":"10.5435\/00124635-200203000-00007","article-title":"Pain management after major orthopaedic surgery: current strategies and new concepts","volume":"10","author":"Sinatra","year":"2002","journal-title":"J\u00a0Am Acad Orthop Surg"},{"key":"10.1016\/j.arth.2020.04.042_bib3","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s10865-008-9191-2","article-title":"Patients\u2019 reasons for electing to undergo total knee arthroplasty impact post-operative pain severity and range of motion","volume":"32","author":"Cremeans-Smith","year":"2009","journal-title":"J\u00a0Behav Med"},{"key":"10.1016\/j.arth.2020.04.042_bib4","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1111\/j.1365-2044.2008.05565.x","article-title":"A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty","volume":"63","author":"Fischer","year":"2008","journal-title":"Anaesthesia"},{"key":"10.1016\/j.arth.2020.04.042_bib5","doi-asserted-by":"crossref","first-page":"282","DOI":"10.2106\/JBJS.E.00173","article-title":"A multimodal analgesia protocol for total knee arthroplasty: a randomized, controlled study","volume":"88","author":"Vendittoli","year":"2006","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2020.04.042_bib6","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/j.1399-6576.2009.02196.x","article-title":"Analgesic efficacy of subcutaneous local anaesthetic wound infiltration in bilateral knee arthroplasty: a randomised, placebo-controlled, double-blind trial","volume":"54","author":"Andersen","year":"2010","journal-title":"Acta Anaesthesiol Scand"},{"key":"10.1016\/j.arth.2020.04.042_bib7","doi-asserted-by":"crossref","first-page":"455","DOI":"10.4055\/cios.2018.10.4.455","article-title":"Effect of surgical-site, multimodal drug injection on pain and stress biomarkers in patients undergoing plate fixation for clavicular fractures","volume":"10","author":"Yoo","year":"2018","journal-title":"Clin Orthop Surg"},{"key":"10.1016\/j.arth.2020.04.042_bib8","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1016\/j.arth.2014.03.034","article-title":"Liposomal bupivacaine versus traditional periarticular injection for pain control after total knee arthroplasty","volume":"29","author":"Bagsby","year":"2014","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.04.042_bib9","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1007\/s11999-009-0728-7","article-title":"Multimodal pain management after total hip and knee arthroplasty at the Ranawat Orthopaedic Center","volume":"467","author":"Maheshwari","year":"2009","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2020.04.042_bib10","first-page":"125","article-title":"The use of local periarticular injections in the management of postoperative pain after total hip and knee replacement: a multimodal approach","volume":"56","author":"Parvataneni","year":"2007","journal-title":"Instr Course Lect"},{"key":"10.1016\/j.arth.2020.04.042_bib11","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1007\/s12630-010-9275-7","article-title":"Local anesthetic systemic toxicity","volume":"57","author":"Dillane","year":"2010","journal-title":"Can J Anaesth"},{"key":"10.1016\/j.arth.2020.04.042_bib12","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/bja\/87.1.27","article-title":"Developments in local anaesthetic drugs","volume":"87","author":"Whiteside","year":"2001","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.arth.2020.04.042_bib13","first-page":"92","article-title":"Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and levobupivacaine","volume":"79","author":"Leone","year":"2008","journal-title":"Acta Biomed"},{"key":"10.1016\/j.arth.2020.04.042_bib14","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1016\/j.arth.2013.03.008","article-title":"Efficacy of multimodal perioperative analgesia protocol with periarticular medication injection in total knee arthroplasty: a randomized, double-blinded study","volume":"28","author":"Kelley","year":"2013","journal-title":"J\u00a0Arthroplasty"},{"issue":"6 Suppl 2","key":"10.1016\/j.arth.2020.04.042_bib15","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.arth.2007.03.034","article-title":"Controlling pain after total hip and knee arthroplasty using a multimodal protocol with local periarticular injections: a prospective randomized study","volume":"22","author":"Parvataneni","year":"2007","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.04.042_bib16","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1093\/bja\/aei242","article-title":"Effects of levobupivacaine and ropivacaine on rat sciatic nerve blood flow","volume":"95","author":"Bouaziz","year":"2005","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.arth.2020.04.042_bib17","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s12871-015-0083-z","article-title":"The effects of adding epinephrine to ropivacaine for popliteal nerve block on the duration of postoperative analgesia: a randomized controlled trial","volume":"15","author":"Schoenmakers","year":"2015","journal-title":"BMC Anesthesiol"},{"key":"10.1016\/j.arth.2020.04.042_bib18","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1007\/s00266-010-9528-4","article-title":"Ischemia of postmastectomy skin after infiltration of local anesthetic with epinephrine: a case report and review of the literature","volume":"34","author":"Hartzell","year":"2010","journal-title":"Aesthetic Plast Surg"},{"key":"10.1016\/j.arth.2020.04.042_bib19","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.arth.2014.04.004","article-title":"The effect of a single dose of preemptive pregabalin administered with COX-2 inhibitor: a trial in total knee arthroplasty","volume":"30","author":"Lee","year":"2015","journal-title":"J\u00a0Arthroplasty"},{"issue":"9 Suppl","key":"10.1016\/j.arth.2020.04.042_bib20","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.arth.2016.03.036","article-title":"The AAHKS Clinical Research award: liposomal bupivacaine and periarticular injection are not superior to single-shot intra-articular injection for pain control in total knee arthroplasty","volume":"31","author":"Jain","year":"2016","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2020.04.042_bib21","doi-asserted-by":"crossref","first-page":"441","DOI":"10.3109\/17453674.2011.581264","article-title":"Pain control after total knee arthroplasty: a randomized trial comparing local infiltration anesthesia and continuous femoral block","volume":"82","author":"Affas","year":"2011","journal-title":"Acta Orthop"},{"key":"10.1016\/j.arth.2020.04.042_bib22","doi-asserted-by":"crossref","first-page":"959","DOI":"10.2106\/JBJS.E.00344","article-title":"Efficacy of periarticular multimodal drug injection in total knee arthroplasty. A randomized trial","volume":"88","author":"Busch","year":"2006","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2020.04.042_bib23","doi-asserted-by":"crossref","first-page":"60","DOI":"10.5435\/JAAOS-D-14-00259","article-title":"Current strategies in anesthesia and analgesia for total knee arthroplasty","volume":"24","author":"Moucha","year":"2016","journal-title":"J\u00a0Am Acad Orthop Surg"},{"key":"10.1016\/j.arth.2020.04.042_bib24","first-page":"124","article-title":"Effects of epinephrine in local anesthetics on the central and peripheral nervous systems: neurotoxicity and neural blood flow","volume":"28","author":"Neal","year":"2003","journal-title":"Reg Anesth Pain Med"},{"key":"10.1016\/j.arth.2020.04.042_bib25","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1136\/rapm-00115550-199520050-00003","article-title":"Epinephrine prolongs duration of subcutaneous infiltration of local anesthesia in a dose-related manner. Correlation with magnitude of vasoconstriction","volume":"20","author":"Liu","year":"1995","journal-title":"Reg Anesth"},{"key":"10.1016\/j.arth.2020.04.042_bib26","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/00000542-200301000-00028","article-title":"On the mechanism by which epinephrine potentiates lidocaine\u2019s peripheral nerve block","volume":"98","author":"Sinnott","year":"2003","journal-title":"Anesthesiology"},{"key":"10.1016\/j.arth.2020.04.042_bib27","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1111\/j.1365-2125.1978.tb01683.x","article-title":"An intradermal study of the local anaesthetic and vascular effects of the isomers of bupivacaine","volume":"6","author":"Aps","year":"1978","journal-title":"Br J Clin Pharmacol"},{"key":"10.1016\/j.arth.2020.04.042_bib28","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1053\/rapm.2000.9853","article-title":"Skin blood flow changes in response to intradermal injection of bupivacaine and levobupivacaine, assessed by laser Doppler imaging","volume":"25","author":"Newton","year":"2000","journal-title":"Reg Anesth Pain Med"},{"key":"10.1016\/j.arth.2020.04.042_bib29","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1093\/bja\/aei095","article-title":"Vasoactive characteristics of bupivacaine and levobupivacaine with and without adjuvant epinephrine in peripheral human skin","volume":"94","author":"Newton","year":"2005","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.arth.2020.04.042_bib30","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/00000542-198907000-00013","article-title":"Effect of ropivacaine on cutaneous capillary blood flow in pigs","volume":"71","author":"Kopacz","year":"1989","journal-title":"Anesthesiology"},{"key":"10.1016\/j.arth.2020.04.042_bib31","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1097\/00000539-200109000-00041","article-title":"A comparison of epidural levobupivacaine 0.5% with or without epinephrine for lumbar spine surgery","volume":"93","author":"Kopacz","year":"2001","journal-title":"Anesth Analg"},{"key":"10.1016\/j.arth.2020.04.042_bib32","first-page":"170958","article-title":"Vasoconstriction potency induced by aminoamide local anesthetics correlates with lipid solubility","volume":"2012","author":"Sung","year":"2012","journal-title":"J\u00a0Biomed Biotechnol"},{"key":"10.1016\/j.arth.2020.04.042_bib33","doi-asserted-by":"crossref","first-page":"2778","DOI":"10.1007\/s00167-015-3723-4","article-title":"No advantage of adrenaline in the local infiltration analgesia mixture during total knee arthroplasty","volume":"25","author":"Schotanus","year":"2017","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.arth.2020.04.042_bib34","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/01.blo.0000147701.24029.cc","article-title":"Soft tissue and intra-articular injection of bupivacaine, epinephrine, and morphine has a beneficial effect after total knee arthroplasty","volume":"428","author":"Lombardi","year":"2004","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2020.04.042_bib35","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1055\/s-0030-1247737","article-title":"Reduced blood loss after total knee arthroplasty with local injection of bupivacaine and epinephrine.","volume":"22(2)","author":"Anderson","year":"2009","journal-title":"J knee Surg"}],"container-title":["The Journal of Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540320304290?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540320304290?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:29:08Z","timestamp":1760120948000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883540320304290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":35,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["S0883540320304290"],"URL":"https:\/\/doi.org\/10.1016\/j.arth.2020.04.042","relation":{},"ISSN":["0883-5403"],"issn-type":[{"value":"0883-5403","type":"print"}],"subject":[],"published":{"date-parts":[[2020,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The Impact of Epinephrine in the Periarticular Injection Cocktail using Ropivacaine for Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Comparison Study","name":"articletitle","label":"Article Title"},{"value":"The Journal of Arthroplasty","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arth.2020.04.042","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}