Liposomal bupivacaine versus bupivacaine/epinephrine after video-assisted thoracoscopic wedge resection†

Parascandola, Salvatore A.; Ibañez, J. Folch; Keir, Graham; Anderson, Jacqueline; Plankey, Michael; Flynn, Deanna; Cody, Candice; Marchi, Lorenzo De; Margolis, Marc; Marshall, M. Blair

doi:10.1093/icvts/ivx044

Cited by 39 publications

(19 citation statements)

References 7 publications

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“…[ 9 , 10 ] Liposomal bupivacaine (EXPAREL) is a prolonged-release formulation of bupivacaine indicated for single-dose administration into the surgical site to produce postsurgical analgesia. [ 11 , 12 ] Several studies have suggested that liposomal bupivacaine significantly alleviates pain and improves quality outcomes in THA patients. [ 3 ] Other studies have drawn an opposite conclusion that liposomal bupivacaine has similar pain control efficacy while increasing the costs for THA patients.…”

Section: Introductionmentioning

confidence: 99%

Liposomal bupivacaine versus traditional bupivacaine for pain control after total hip arthroplasty

Ma¹,

Wang

Jiang³

et al. 2017

Medicine

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Background:In the past, the efficacy of local infiltration of liposomal bupivacaine for total hip arthroplasty (THA) patients was in debate. Therefore, this meta-analysis was conducted to determine whether local infiltration of liposomal bupivacaine provides better pain relief after THA.Methods:We searched Web of Science, PubMed, Embase, and the Cochrane Library databases to the April 2017. Any studies comparing liposomal bupivacaine and traditional bupivacaine were included in our meta-analysis. The outcomes included visual analog scale (VAS) at 24, 48, and 72 hours, total morphine consumption at 24 hours, and the length of hospital stay. We assessed the pooled data using a random-effect model.Results:Six studies were finally included in this meta-analysis. Our pooled data analysis demonstrated that liposomal bupivacaine was more effective than the traditional bupivacaine in terms of VAS at 24 hours (P = .018) and the length of hospital stay (P = .000). There was no significant difference in terms of the VAS at 48 and 72 hours and total morphine consumption at 24 hours (P >.05).Conclusion:Compared with the traditional bupivacaine, liposomal bupivacaine shows better pain control at 24 hours and reduces the length of hospital stay after THA. Its economic costs must be assessed in multimodal center randomized controlled trials when being recommended as a long-acting alternative analgesic agent for a THA patient.

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Section: Introductionmentioning

confidence: 99%

Liposomal bupivacaine versus traditional bupivacaine for pain control after total hip arthroplasty

Ma¹,

Wang

Jiang³

et al. 2017

Medicine

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“…15 Parascandola et al found LB to be more effective than bupivacaine with epinephrine in video assisted thoracic resections. 16…”

Section: Discussionmentioning

confidence: 99%

Fifty Percent Reduction in Narcotic Use After Minimally Invasive Cardiac Surgery Using Liposomal Bupivacaine

Castillo-Sang

Bartone

Palmer

et al. 2019

Innovations�(Phila)

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Objective Minimally invasive cardiac surgery via a right minithoracotomy (RMT) is a common approach to different valve pathologies, tumor resection, and atrial septal defect (ASD) closure. We studied intraoperative field block using liposomal bupivacaine (LB) in these operations. Methods Consecutive 171 minimally invasive RMTs (fourth intercostal space) were studied, and patients in cardiogenic or septic shock, intravenous drug abuse, and those re-explored were excluded ( n = 12). An early cohort was treated with standard postoperative analgesia while another underwent intraoperative field block with LB immediately after incision. We compared postoperative pain level, narcotic utilization (morphine milligram equivalent), and intensive care unit (ICU) and hospital length of stay. Results The procedures included 48 isolated mitral valve replacements (MVR); 2 MVR with other procedures; 93 mitral valve repairs (MVRr); 9 MVRr with other procedures; 4 isolated tricuspid valve repairs; 2 myxoma resections; 1 ASD closure. There were 13 patients in the non-LB group and 146 patients in the LB group. Use of LB decreased mean postoperative narcotic utilization by 50% ( P = 0.003). The LB group had lower pain levels on postoperative day 1 ( P = 0.039), which continued through postoperative day 5 ( P = 0.030). We found no difference in ICU or hospital length of stay between groups. There were no complications from LB field block. Conclusions LB field block decreases postoperative pain and narcotic utilization after cardiac surgery via a RMT, but it does not reduce length of stay. The technique is safe and should be considered in all patients undergoing RMT cardiac surgery.

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“…Orthopedic surgery, general surgery, and thoracic surgery, as well as other specialties, have employed this medication in a variety of studies in an effort to reduce the amount of opioid medications that patients are given and to provide longer postsurgical anesthesia. [11][12][13][14] These studies and others suggest that liposomal bupivacaine may be an important adjunct to postsurgical pain with the goals of improved pain, a longer duration of pain control, and reduced dependence on and use of opioid analgesics. A more thorough review of these studies was completed via a Cochrane review published in 2016 by Hamilton et al 15 The conclusion of this review, which included 9 studies that met strict criteria (1377 participants), showed that although the studies did demonstrate reduced pain as compared with placebo, there was no appreciable difference in comparison with standard bupivacaine in the treatment of postsurgical pain.…”

Section: Mean Liquid Oral Intakementioning

confidence: 95%

A Randomized Single‐Blinded Trial of Posttonsillectomy Liposomal Bupivacaine among Adult Patients

Olson

Moore

Price

2018

Otolaryngol.--head neck surg.

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The injection of liposomal bupivacaine in the posttonsillectomy wound bed demonstrates improved pain intensity scores for the first 24 hours after surgery with no adverse complications noted in comparison with patients who did not receive the injection. Given the limited pain reduction and increased cost, use of liposomal bupivacaine in adult tonsillectomy patients appears to have minimal indication for use.

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Liposomal bupivacaine versus bupivacaine/epinephrine after video-assisted thoracoscopic wedge resection†

Abstract: Thoracic surgery patients who have blocks performed with liposomal bupivacaine require fewer analgesics postoperatively. This may decrease complications related to poor pain control and decrease side effects related to narcotic use in our patient population.

Cited by 39 publications

References 7 publications

Liposomal bupivacaine versus traditional bupivacaine for pain control after total hip arthroplasty

Liposomal bupivacaine versus traditional bupivacaine for pain control after total hip arthroplasty

Fifty Percent Reduction in Narcotic Use After Minimally Invasive Cardiac Surgery Using Liposomal Bupivacaine

A Randomized Single‐Blinded Trial of Posttonsillectomy Liposomal Bupivacaine among Adult Patients

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