Perineural Liposomal Bupivacaine for Postoperative Pain Control in Patients Undergoing Upper Extremity Orthopedic Surgery: A Prospective and Randomized Pilot Study. | LitMetric
Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
Published: January 2016
AI Article Synopsis
Article Abstract
Background: Upper extremity surgery is commonly performed in the ambulatory setting and is associated with moderate to severe postoperative pain.
Methods: Patients scheduled for upper extremity orthopedic surgery with a peripheral nerve block were randomized to receive either an ultrasound-guided single-injection supraclavicular block or ultrasound-guided median, ulnar, and radial nerve blocks (forearm blocks) performed at the level of the mid to proximal forearm with liposomal bupivacaine (Exparel) combined with a short-acting supraclavicular block. A sham block was performed in an attempt to blind enrollees in the control group. We administered the EuroQol 5D-5L questionnaire preoperatively and on postoperative days 1-3 and considered the results the primary outcome of our investigation. Block procedure times, postanesthesia care unit (PACU) length of stay, instances of nausea/vomiting, need for narcotic administration, and patient satisfaction were also assessed.
Results: We observed no significant differences in postoperative EuroQol scores between the 2 groups and no significant differences in patient demographics, PACU length of stay, or side effects in the PACU. In some instances, the short-acting supraclavicular block resolved in the PACU, and these patients reported higher pain scores and required titration of analgesics prior to discharge.
Conclusion: Larger prospective studies are needed to determine the safety and efficacy of liposomal bupivacaine in patients undergoing upper extremity surgery. Liposomal bupivacaine is currently only approved for local anesthetic infiltration use.
Department of Anesthesia, Shengzhou People's Hospital (Shengzhou Branch of the First Affiliated Hospital of Zhejiang University School of Medicine, the Shengzhou Hospital of Shaoxing University), Shaoxing, China.
Background: This review aimed to provide evidence on the efficacy of liposomal bupivacaine as compared to standard bupivacaine for intercostal nerve blocks (ICB) in patients undergoing minimally invasive thoracic surgery.
Methods: Randomized controlled trials (RCTs) and comparative observational studies published on the databases of PubMed, CENTRAL, Web of Science, and Embase up to June 20, 2024, were included. Total opioid consumption in morphine equivalents, pain scores, and length of hospital stay (LOS) were compared.
The analgesic efficacy and safety of liposomal bupivacaine (LB) in third molar extraction was evaluated in this phase 3, double-blind, placebo-controlled study of subjects undergoing bilateral third molar extraction. Subjects were randomized 2: 1 to infiltration with LB (133 mg/10 mL) or placebo, and received opioid rescue medication as needed. Primary efficacy measure was cumulative area under the curve (AUC) of numeric rating scale (NRS) pain severity scores through 48 hours (AUC of NRS0-48) postsurgery.
Abstract: Local anesthetics as a part of intraarticular therapies (IATs) are widely used for treating knee osteoarthritis (KOA). Whether substitution of liposomal bupivacaine (LB) for lidocaine is safe and effective in reducing incidence of injection-emergent adverse events after IATs remains unclear.
Methods: We recruited outpatients who had a clinical diagnosis of KOA and decided to receive IATs from November 2023 to April 2024.
