Liposomal bupivacaine decreases opioids in adolescents undergoing posterior spinal fusion
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Key takeaways:
- Adolescents who received liposomal bupivacaine during posterior spinal fusion received fewer opioids.
- The addition of liposomal bupivacaine to a standard pain management protocol may be warranted.
Results showed a postoperative pain management protocol with liposomal bupivacaine decreased opioids and length of stay and improved ambulation in patients with adolescent idiopathic scoliosis who underwent posterior spinal fusion.
Suken A. Shah, MD, and colleagues split 119 consecutive patients (mean age, 14.5 years) who underwent posterior spinal fusion for adolescent idiopathic scoliosis into two groups: a group of 53 patients who received liposomal bupivacaine (LB) with a standard multimodal pain management protocol and a group of 66 patients who received just the standard multimodal pain management protocol. According to the study, patients in the LB group received an intraoperative local infiltration of 4 mg/kg of LB as an erector spinae block prior to muscle closure.
Researchers found patients in the LB group received fewer opioids during their stay compared with patients in the standard protocol group (44.5 oral morphine equivalents [OMEs] vs. 70.2 OMEs; P < .001). They noted patients in the LB group had shorter length of stay compared with patients in the standard protocol group (2.43 vs. 2.74 days; P = .005) and ambulated further than patients in the standard protocol group (postoperative day 1, P = .003; postoperative day 2, P = .002).
“The importance of adequate postoperative pain control in these patients has been well documented but is now challenged by the opioid crisis both from a medical perspective and a health care cost perspective,” Shah and colleagues wrote.
“Our results suggest LB also is associated with decreased hospital LOS and greater mobility in terms of ambulation distance,” they concluded.
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