Intraoperative Infiltration of Liposomal Bupivacaine vs Bupivacaine Hydrochloride for Pain Management in Primary Total Hip Arthroplasty: A Prospective Randomized Trial

Perets, Itay; Walsh, John P.; Mu, Brian; Yuen, Leslie C.; Ashberg, Lyall; Battaglia, Muriel R.; Domb, Benjamin G.

doi:10.1016/j.arth.2017.09.013

Cited by 27 publications

(46 citation statements)

References 28 publications

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“…Among them, 5 studies was non-RCT, [9,11,13–15] and 7 studies were RCTs. [7,16–21] Nine studies [7,9,13,15,16,18–21] reported postoperative pain according to VAS scale. Nine studies [9,13,15–21] mentioned total morphine at 24,48 h. Nine studies [9,11,13–16,18,20,21] evaluated length of hospital stay.…”

Section: Resultsmentioning

confidence: 99%

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The efficacy of local liposomal bupivacaine infiltration on pain and recovery after Total Joint Arthroplasty

Zhao

Zhang

et al. 2019

Medicine

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Background:Total Joint Arthroplasty (TJA) is gradually emerging as the treatment of choice for end-stage osteoarthritis. In the past, Perioperative liposomal bupivacaine treatment is still a controversial subject in TJA. Therefore, we write this systematic review and meta-analysis to evaluate the efficacy of liposomal bupivacaine on pain and recovery after TJA.Materials and methods:Embase, Pubmed, and Cochrane Library were comprehensively searched. Randomized controlled trials (RCTs), cohort studies were included in our meta-analysis. Twelve studies that compared liposomal bupivacaine groups with placebo groups were included in our meta-analysis. The research was reported according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. RCTs were included in our meta-analysis.Results:Our study demonstrated that liposomal bupivacaine group was as effective as the placebo group in term of VAS score at 24 h (P = .09), 48 h (P = .97); Postoperative nausea (P = .72); and LOS (0.27). There was significant difference in terms of total morphine consumption at 24 h (P < .0001), 48 h (P = .0008).Conclusion:Our meta-analysis demonstrated that liposomal bupivacaine has similar pain control and functional recovery after TJA which compared with the control group. However, we still need large sample size, high-quality studies to explore the relationship between complications and dose response to give the final conclusion.

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Section: Resultsmentioning

confidence: 99%

“…Nine studies [9,13,15–21] mentioned total morphine at 24,48 h. Nine studies [9,11,13–16,18,20,21] evaluated length of hospital stay. Four studies [7,16,17,21] evaluated the incidence of nausea.…”

Section: Resultsmentioning

confidence: 99%

The efficacy of local liposomal bupivacaine infiltration on pain and recovery after Total Joint Arthroplasty

Zhao

Zhang

et al. 2019

Medicine

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“…Several studies reported lower pain scores as the benefits of extended release bupivacaine exhibited promising results [12][13][14][15][16]. However, as usage grew, results of several randomized trials, made even devoted users skeptical as the data exhibited non-superior results when compared to other modalities [7][8][9][10]. As a result, many orthopaedic surgeons have moved away from use of liposomal bupivacaine citing high cost for no presumed benefit [9].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, liposomal bupivacaine gained popularity due to its extended release and initial, promising results [6]. However, not long after popularity grew, a few randomized trials reported data noting non-superior results when comparing liposomal bupivacaine to other pain modalities (within an operating multi-modal pain protocol) [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for liposomal bupivacaine resistance after total hip or knee arthroplasties: a retrospective observational cohort in 237 patients

Buzin

Gianakos

et al. 2020

Patient Saf Surg

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Purpose: Liposomal bupivacaine demonstrated promise decreasing postoperative pain in total hip and total knee arthroplasty (THA/TKA). Some randomized trials have shown non-superior results; however, confounding variables were not accounted for in such analyses. This study attempts to determine risk factors associated with failure of pain management in patients receiving liposomal bupivacaine. Methods: Postoperative pain scores were collected following primary or revision arthroplasties between January 2016 and December 2017. Retrospective analysis of institutional total joint quality and outcomes registry was screened and patients undergoing primary or revision arthroplasties who completed a multi-modal pain management including liposomal bupivacaine were included in the study. Patients with a history of infection/ deviated from the institutional pain management protocol were excluded. Results: A total of 237 patients were included for analysis. Younger patients less than 64 years old had significantly higher pain scores between 0 and 12 h and > 24 h. Active smokers had significantly higher pain scores between 0 and 6 h and > 24 h. Patients with a history of opioid use/pain management had significantly higher pain scores at 6-12 h and 24-48 h. Regression analysis indicated risk factors for resistance to liposomal bupivacaine are younger patients less than 64 years old, those undergoing primary THA, and patients with a history of smoking/pain management/opioid use. Conclusion: We identify risk factors for resistance to liposomal bupivacaine, which include younger age less than 64 years old, history of smoking/pain management/opioid use. Future studies should use these risk factors as exclusion criteria when using liposomal bupivacaine or initiating any randomized trials regarding efficacy.

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“…In a 3-arm randomized clinical trial, Johnson et al found that continuous posterior lumbar plexus block or periarticular infiltration (PAI) with liposomal bupivacaine, ketorolac, and epinephrine provides superior postoperative analgesia compared with PAI with ropivacaine, ketorolac, and epinephrine 105 . However, in a prospective randomized trial, the superiority of liposomal bupivacaine was not confirmed when compared with control (bupivacaine hydrochloride alone) 106 .…”

Section: Multimodal Pain Control/perioperative Pain Managementmentioning

confidence: 94%

What’s New in Hip Replacement

Glassman

2018

The Journal of Bone and Joint Surgery

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Intraoperative Infiltration of Liposomal Bupivacaine vs Bupivacaine Hydrochloride for Pain Management in Primary Total Hip Arthroplasty: A Prospective Randomized Trial

Cited by 27 publications

References 28 publications

The efficacy of local liposomal bupivacaine infiltration on pain and recovery after Total Joint Arthroplasty

The efficacy of local liposomal bupivacaine infiltration on pain and recovery after Total Joint Arthroplasty

Risk factors for liposomal bupivacaine resistance after total hip or knee arthroplasties: a retrospective observational cohort in 237 patients

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