Background: There has been a surge in interest with regard to the utility of liposomal bupivacaine as part of a perioperative pain management protocol. The current study was proposed to critically assess the efficacy of liposomal bupivacaine as a local anesthetic for pain relief following orthopaedic procedures.
Methods: A systematic review of prospective, randomized trials involving liposomal bupivacaine was performed using searches of the PubMed, Embase, and Cochrane databases. The primary outcomes of interest included postoperative subjective pain scores and narcotic consumption. The length of stay and postoperative mobility were reviewed as secondary outcomes.
Results: Twenty-seven studies met inclusion criteria and were included for review. Twelve of 17 studies concluded that periarticular or local infiltrative liposomal bupivacaine offered no additive benefit compared with other local anesthetic injections. Peripheral nerve blocks without liposomal bupivacaine conferred more optimal pain relief and decreased narcotic consumption in the immediate postoperative period when compared with liposomal bupivacaine, with no differences thereafter. Twelve studies listed a conflict of interest related to the drug manufacturer (Pacira Pharmaceuticals). Eight of these studies (67%) demonstrated clinical superiority of liposomal bupivacaine when compared with the study control. In the 15 studies that did not show a conflict of interest, only 1 study (7%) demonstrated therapeutic superiority with use of periarticular liposomal bupivacaine when compared with a historical cohort that received no local or regional anesthesia.
Conclusions: Current prospective, randomized controlled trials in patients undergoing orthopaedic surgery fail to support the routine use of liposomal bupivacaine compared with other local injectable analgesics, particularly in the setting of knee replacement surgery. We were unable to find consistent support for the potential of superior pain relief and narcotic use reduction with the use of liposomal bupivacaine.
Level Of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2106/JBJS.RVW.18.00192 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The 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.
Novel Ultrasound-Guided Sub-Piriformis Injection (SPI) May Produce Effective Analgesia for Both Open and Arthroscopic Hamstring Repair: A Case Report.
Cureus
November 2024
Education, Twin Oaks Anesthesia Services, Wesley Chapel, USA.
Open or arthroscopic repair of hamstring tear requires both hard and soft, posterior and proximal thigh analgesia. Regional injections to completely relieve this unique pain are not available to the best of our knowledge. We present a novel, single injection, performed under ultrasound guidance, that utilizes the deep piriformis space.
View Article and Find Full Text PDFLetter to the editor regarding "Recovery quality of transversus abdominis plane block with liposomal bupivacaine after cesarean delivery: A randomized trial".
J Clin Anesth
December 2024
The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Department of Anesthesiology and Perioperative Medicine, Wenzhou, China. Electronic address:
Objective: To compare the postoperative complication rates of anal sacculectomy procedures in dogs treated with or without liposomal bupivacaine (LB).
Methods: Medical records of 397 client-owned dogs treated with closed anal sacculectomy between 2016 and 2023 were retrospectively identified and grouped on the basis of administration of LB (LB group) or not (non-LB group). Details of short-term (< 15 days) postoperative complications were recorded from physical examination and client communication notes as well as referral documents and compared between groups.
Assessing Use and Familiarity of Enhanced Recovery After Surgery Elements in Pediatric Orthognathic Surgery.
J Craniofac Surg
October 2024
Department of Plastic Surgery, University of California, Irvine.
Enhanced recovery after surgery (ERAS) protocols have informed perioperative care across multiple surgical specialties, optimizing patient outcomes through surgical stress management and accelerated recovery. This study evaluates the familiarity and adoption of ERAS elements among craniofacial and oral and maxillofacial surgeons in pediatric orthognathic surgery, a field where a formal ERAS protocol has not been established. A closed-ended survey of 102 surgeons was conducted to assess familiarity with and utilization of 14 ERAS elements.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!