Yale Steroid Enhanced Versus Exparel Nerveblock TKA Part 2

This study is the second part of a trial comparing two pain management approaches used during and after total knee replacement (TKA) surgery. One approach uses a nerve block containing Exparel, a long-acting local anaesthetic. The other uses a nerve block with a steroid and standard local anaesthetic added to the mix. Both are injected around the knee nerves before surgery to control post-operative pain. The goal is to find which combination provides better pain relief, less opioid use, and faster recovery. Adults classified as low to moderate surgical risk (ASA classes I–III) who are having elective, primary, bilateral total knee replacement under spinal anaesthesia are eligible. Patients are excluded if they are pregnant, have cognitive or language barriers preventing follow-up questionnaires, have clotting disorders, are allergic to the study medications, have been on opioids in the month before surgery, have uncontrolled diabetes, active infections, immune compromise, severe nerve damage, or kidney/liver dysfunction. Participants receive their assigned nerve block before surgery and are followed up with online questionnaires about pain and function during recovery. This study matters because opioid-sparing pain control after joint replacement is a major priority in modern surgery — identifying the best combination could reduce both patient suffering and opioid-related risks.