Liposomal bupivacaine provided pain relief similar to interscalene nerve block for shoulder arthroplasty
Patients who underwent shoulder arthroplasty and received liposomal bupivacaine experienced overall pain relief similar to that of patients who received interscalene nerve block, according to results. In addition, patients treated with liposomal bupivacaine had no increase in complications or length of stay and had a decrease in narcotic requirements on the day of surgery.
Researchers randomly assigned 57 patients undergoing primary shoulder arthroplasty to receive either intraoperative local infiltration of liposomal bupivacaine or a preoperative interscalene nerve block. Primary outcome was postoperative average daily VAS scores for 4 days, while secondary outcomes included opioid consumption, length of stay and complications.
Results showed a significant increase in pain in the first 8 hours postoperatively among patients who received liposomal bupivacaine. Investigators noted a significant increase in intravenous morphine equivalents at 13 hours to 16 hours in the interscalene nerve block group. However, on the day of surgery and 24 hours postoperatively, the overall average pain score did not significantly differ between the liposomal bupivacaine and interscalene nerve block groups.
In the first 24 hours after surgery, patients in the liposomal bupivacaine group had a significantly decreased opioid requirement. While researchers noted no significant differences in opioid requirements on postoperative day 1 between the two groups, the liposomal bupivacaine group had a trend toward higher narcotic requirements on postoperative day 2. However, on postoperative day 3, both treatment groups had no differences in opioid requirements. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.