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Admixture of Liposomal Bupivacaine and Bupivacaine Hydrochloride for Peripheral Nerve Blocks in Adolescents Undergoing Orthopedic Surgery: An Observational Cohort Study.
J Clin Med
December 2024
Department of Anesthesiology, Duke University Medical Center, DUMC 3094, Durham, NC 27710, USA.
: In 2021, the Food and Drug Administration approved liposomal bupivacaine injectable suspension for single-dose infiltration in patients ≥ 6 years of age. Liposomal bupivacaine and bupivacaine hydrochloride admixtures may also be administered off-label for pediatric regional anesthesia including peripheral nerve blocks (PNBs). This single-injection, long-acting technique is not well described in pediatrics but may have benefits over traditional continuous catheter-based systems.
View Article and Find Full Text PDFThe Use of Liposomal Bupivacaine for Pain Control After Shoulder Surgery: A Systematic Review and Meta-analysis.
Am J Sports Med
January 2025
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA.
Background: Liposomal bupivacaine (LB) is a relatively novel anesthetic agent used in the management of postoperative pain in patients who have undergone shoulder surgery.
Purpose: To explore the literature on LB in the setting of shoulder surgery and assess its efficacy and utility in managing postoperative pain.
Study Design: Systematic review and meta-analysis; Level of evidence, 1.
Randomized Clinical Trial Comparing Mixed Liposomal Bupivacaine versus Continuous Catheter for Interscalene Block during Shoulder Arthroplasty: A Comparison of Analgesia, Patient Experience, and Cost.
J Shoulder Elbow Surg
November 2024
Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
Background: Continuous interscalene catheters extend analgesia beyond 24 hours but are resource-intensive, while the efficacy of liposomal bupivacaine for single-injection interscalene blocks remains uncertain. The purpose of this investigation was to examine the analgesic efficacy, quality of recovery, and treatment costs between interscalene nerve block using either an indwelling catheter or single shot block using liposomal bupivacaine, in patients undergoing shoulder arthroplasty.
Methods: In this single-center, parallel, unblinded, randomized clinical trial, 83 patients undergoing primary shoulder arthroplasty were assigned to either a continuous interscalene catheter group (n=44) or a single-injection liposomal bupivacaine interscalene block group (n=39).
Efficacy of dexamethasone or clonidine as adjuvants in interscalene brachial plexus block for preventing rebound pain after shoulder surgery: a randomized clinical trial.
Braz J Anesthesiol
November 2024
Universidade Federal do Maranhão (UFMA), Programa de Pós-Graduação em Saúde do Adulto, São Luis, MA, Brazil. Electronic address:
Background: Rebound pain is believed to involve both nociceptive pain due to insufficient analgesia and hyperalgesia induced by regional anesthesia. Adjuvant's addition could prevent rebound pain. This study aimed to determine if the addition of dexamethasone or clonidine to local anesthetic when performing interscalene block could prevent rebound pain.
View Article and Find Full Text PDFComparison of analgesic efficacy of continuous perineural catheter, liposomal bupivacaine, and dexamethasone as an adjuvant for interscalene block in total shoulder arthroplasty: a triple-blinded randomized controlled trial.
J Shoulder Elbow Surg
February 2025
Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai West and Morningside Hospitals, New York, NY, USA.
Background: Interscalene catheters (ISC) are considered as the gold standard for perioperative pain control after total shoulder arthroplasty. Liposomal bupivacaine (LB) for interscalene blocks (ISBs) and the addition of dexamethasone to ISBs have both presented as additional options for extended analgesia. We aimed to compare the efficacy of LB to a single-shot ISB (SISB) with added dexamethasone to an ISC.
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