Liposomal bupivacaine incisional injection in single-level lumbar spine surgery

Puffer, Ross C.; Tou, Kevin; Winkel, Rose E.; Bydon, Mohamad; Currier, Bradford L.; Freedman, Brett A.

doi:10.1016/j.spinee.2016.06.013

Cited by 50 publications

(45 citation statements)

References 7 publications

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“…The results were similar to the increase in postoperative opioid consumption among NT patients receiving sterile saline versus LB in our study. In 2016, Puffer et al 26 compared a prospective cohort of patients who received LB after a single-level lumbar microdiscectomy to a retrospective matched cohort of patients who did not receive local anesthetics. They found that even though patients who received LB collectively spent less time on IV narcotics, this did not translate into a reduction in total MME or VAS pain scores in the postoperative period.…”

Section: Efficacy Of Liposomal Bupivacaine In Lumbar Spine Surgerymentioning

confidence: 99%

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Brown¹,

Weir²,

Shasti³

et al. 2018

Int J Spine Surg

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Background: Postoperative pain management in spine surgery holds unique challenges. The purpose of this study is to determine if the local anesthetic liposomal bupivacaine (LB) reduces the total opioid requirement in the first 3 days following posterior lumbar decompression and fusion (PLDF) surgery for degenerative spondylosis.Methods: Fifty patients underwent PLDF surgery in a prospective randomized control pilot trial between August 2015 and October 2016 and were equally allocated to either a treatment (LB) or a control (saline) group. Assessments included the 72-hour postoperative opioid requirement normalized to 1 morphine milligram equivalent (MME), visual analog scale (VAS), and hospital length of stay.Results: LB did not significantly alter the 72-hour postoperative opioid requirement compared to saline (11.6 vs. 13.4 MME, P ¼ .40). In a subgroup analysis, there was also no significant difference in opioid consumption among narcotic-naive patients with either LB or saline. Among narcotic tolerant patients, however, opioid consumption was higher with saline than LB (20.6 MME vs. 13.3 MME, P ¼ .048). Additionally, pre-and postoperative VAS scores and hospital length of stay were not significantly different with either LB or saline.Conclusions: In the setting of PLDF surgery, LB injections did not significantly reduce the consumption of opioids in the first 3 postoperative days, nor did the hospital length of stay or VAS pain scores, compared to saline. However, LB could be beneficial in reducing the consumption of opioids in narcotic-tolerant populations.Level of Evidence: 2.

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Section: Efficacy Of Liposomal Bupivacaine In Lumbar Spine Surgerymentioning

confidence: 99%

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Brown¹,

Weir²,

Shasti³

et al. 2018

Int J Spine Surg

View full text Add to dashboard Cite

show abstract

“…In a mixed prospective/retrospective analysis, Puffer et al, found that patients undergoing a single-level microdiscectomy who received LB used significantly less time using IV narcotics when compared to a control group who did not receive a local anesthetic. This same study, however, found no significant difference in VAS scores or total opioid consumption [3].…”

Section: Citation: Gannon Ej Cornett Ca Larson Ep Lyden Er (2018) mentioning

confidence: 69%

“…Adequate pain control has been linked to improved quality of life, patient satisfaction, and clinical outcomes [2]. Obtaining sufficient postoperative pain control can also allow for earlier mobilization and has the ability to shorten a patient's LOS thereby decreasing hospital costs [3,4]. The current standard therapy for postoperative pain management consists of opioid medications, however, with the current epidemic of overdoses and abuse, physicians must consider the potential risks when formulating a postoperative pain regimen [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…The importance of postoperative pain control and potential detrimental side-effects of opioid medications lends to the importance of finding alternative analgesic interventions with improved adverse-effect profiles [7]. Local anesthetic infiltration is one such modality that has been used as an adjunct postoperative analgesic [3]. The use of standard bupivacaine produces an anesthetic effect that lasts about 9 hours [8].…”

Section: Introductionmentioning

confidence: 99%

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The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Gannon¹

2018

SCTI

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“…Puffer et al recently described liposomal bupivacaine use in adults undergoing single‐level lumbar spinal surgery and showed a decrease in the total time using postoperative intravenous opioid medication yet no difference in total morphine equivalent doses or average postoperative visual analog pain scale between groups. A review article by Bergese et al assessed pooled data from 10 studies in five different surgical models and demonstrated reductions in total postsurgical consumption of opioid rescue medication, time to use of first use of opioid rescue medication, and in proportion of patients requiring opioid rescue medications at 72 hours in patients who received liposomal bupivacaine.…”

Section: Introductionmentioning

confidence: 99%