Brachial plexus block with liposome bupivacaine for shoulder surgery linked with decreased opioid use
After shoulder surgery, a single-injection of ultrasound-guided brachial plexus block with liposome bupivacaine offered analgesia through 48 hours postoperatively and decreased opioid use compared with placebo, according to recently published results.
Researchers identified 155 patients who underwent total shoulder arthroplasty or rotator cuff repair and randomly assigned 69 patients to receive an ultrasound-guided brachial plexus block with bupivacaine liposome injectable suspension (Exparel 133 mg; Pacira BioSciences Inc.), 15 patients to liposome bupivacaine 266 mg and 71 patients to placebo added to a standard analgesia protocol. The area under the curve of the VAS pain intensity score through 48 hours postoperatively was the primary endpoint. Other outcomes included total opioid consumption, percentage of opioid-free patients and time to first opioid rescue through 48 hours. Investigators collected pharmacokinetic samples through 120 hours and on days 7 and 10. Adverse events were recorded.
Results showed brachial plexus block with liposomal bupivacaine correlated with significantly decreased pain scores through 48 hours compared with placebo (136.4 vs. 254.1). Investigators noted opioid consumption and median time to opioid rescue were significantly decreased with liposomal bupivacaine through 48 hours compared with placebo (4.2 hours vs. 0.6 hours). The percentage of opioid-free patients was also significantly improved with liposomal bupivacaine through 48 hours compared with placebo. Patients who were treated with liposomal bupivacaine were nine-times more likely to be opioid free through 48 hours compared with patients treated with placebo. – by Monica Jaramillo
Disclosures: Patel reports he received research funding from Pacira BioSciences Inc. Please see the full study for a list of all other authors’ relevant financial disclosures.