June 26, 2017
Patients undergoing shoulder arthroplasty who received a standardized multimodal pain management as well as intraoperative liposomal bupivacaine and intravenous dexamethasone had a significant reduction in length of stay, overall narcotic use and VAS pain scores, according to results.
Howard D. Routman, DO, and his colleagues divided 55 patients undergoing shoulder arthroplasty into two groups, both of which received perioperative multimodal management with preoperative and postoperative intravenous (IV) and oral narcotics, gabapentin, nonsteroidal anti-inflammatory drugs, acetaminophen and single-injection interscalene block. After the skin incision and liposomal bupivacaine injected at surgery, patients in cohort 2 received 8 mg to 10 mg of IV dexamethasone, according to researchers. Researchers analyzed patients who did and did not use preoperative narcotics together and separately, and evaluated hospital length of stay, narcotic use and VAS pain before and after the change in perioperative protocol.