A Prospective, Randomized, Open-Label Study Comparing an Opioid-Sparing Postsurgical Pain Management Protocol With and Without Liposomal Bupivacaine for Full-Arch Implant Surgery

Iero, Phillip T; Mulherin, D.; Jensen, O N; Berry, Tom; Danesi, Hassan; Razook, Samuel J.

doi:10.11607/jomi.5938

Cited by 20 publications

(10 citation statements)

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“…The addition of LB to a standard opioid-sparing regimen may also provide benefits in other major oral procedures, given that this has been previously demonstrated to reduce postsurgical pain after full-arch implant surgery in a randomized, open-label study. 14 The results from the present study and these past studies demonstrate y One patient did not provide a year of birth. z One patient did not identify as female or male.…”

Section: Discussionsupporting

confidence: 54%

A Retrospective Cross-Sectional Study of the Effect of Liposomal Bupivacaine on Postoperative Opioid Prescribing After Third Molar Extraction

Lieblich

Misiek

Olczak

et al. 2021

Journal of Oral and Maxillofacial Surgery

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Reducing opioid prescriptions after third molar extraction may decrease the risk of opioid dependence. This study compared prescribed morphine milligram equivalents (MMEs) in patients undergoing mandibular third molar removal with and without use of liposomal bupivacaine (LB).Methods: This retrospective cross-sectional study included deidentified data from electronic medical records of patients who underwent extraction of $1 partial bony-or full bony-impacted mandibular third molar at 2 oral surgery centers in the United States in 2012 or 2018. The primary predictor variable was use of LB 133 mg. The primary outcome variable was total prescribed opioids in MMEs. The secondary outcome variable was rate of prescription refills. Both univariate and multivariable regression analyses were used to compare MMEs between groups with a significance level of P < .05.Results: The study sample included 600 subjects (n = 300 each for LB and non-LB groups). Mean age (22-24 years) and sex distribution (55%-58% female) were comparable between groups, although significant differences were observed in anesthesia type and race distribution (P < .05). In univariate analysis, the LB group was prescribed 59% fewer MMEs than the non-LB group (47.1 vs 113.8 MMEs; rate ratio, 0.41 [0.39-0.44]; P < .0001). After adjustment for age, sex, anesthesia type, American Society of Anesthesiologists physical status classification, and complications, the LB group was prescribed significantly fewer total opioids (adjusted MMEs, 44.9 vs 109.5; rate ratio, 0.41 [95% confidence interval, 0.39-0.44]; P < .0001) and had a significantly lower opioid prescription refill rate (3.3% vs 7.7%; odds ratio, 0.38 [95% confidence interval, 0.16-0.90]; P = .028) than the non-LB group. Complication rates were comparable between groups.Conclusions: Patients undergoing third molar extraction and receiving LB were prescribed significantly fewer opioids than patients who did not receive LB, with a lower refill rate. Use of LB may reduce opioid prescriptions for postsurgical analgesia.

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Section: Discussionsupporting

confidence: 54%

A Retrospective Cross-Sectional Study of the Effect of Liposomal Bupivacaine on Postoperative Opioid Prescribing After Third Molar Extraction

Lieblich

Misiek

Olczak

et al. 2021

Journal of Oral and Maxillofacial Surgery

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“…In another prospective, randomized, open-label study, conducted by Iero, et al 69 patients (n = 34 LB, n = 35 placebo) undergoing full-arch implant surgery were included. The authors concluded that LB 266 mg for full-arch implant placement significantly reduces post-surgical pain and clinically relevant decline in opioid consumption [11]. In both of the above mentioned studies, the adverse effects were comparable between the LB and placebo groups [10,11].…”

Section: Literature Reviewmentioning

confidence: 93%

Evolving Role of Liposomal Bupivacaine in Managing Post-Surgical Analgesia in Oral Surgery

Gangwani¹

2019

Res Rep Oral Maxillofac Surg

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“…(2) individuals consuming smokeless tobacco products and/or areca nut; (3) dual smoker, i.e., persons smoking tobacco along with other nicotinic products including waterpipe, bidi, and electronic cigarettes; (4) individuals who consumed alcohol habitually; (5) completely edentulous individuals; (6) individuals with maligned dentition; (7) patients suffering from medical conditions such as diabetes mellitus, renal and hepatic disorders, cardiovascular diseases, and patients suffering from the HIV infection; (8) gestation and/or nursing individuals; (9) individuals who reported to have utilized steroids, NSAIDs, probiotics, antibiotics and bisphosphonates over the past 3 months.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…Furthermore, the International Congress of Implantologists (ICOI) also suggested SPP to be utilized as a diagnostic parameter for implant failure and periimplantitis [4] The numeric pain rating scale (NPRS), developed by Downie et al [5], is a valid and reliable scale often utilized to examine the SPP in subjects with musculoskeletal diseases, for instance, osteoarthritis [6]. The NPRS has also been utilized to evaluate links with dental implant surgeries [7].…”

Section: Introductionmentioning

confidence: 99%

Association of Self-Rated Pain with Clinical Peri-Implant Parameters and Cytokine Profile in Smokers and Never Smokers with and without Peri-Implantitis

et al. 2021

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To examine the association between self-perceived pain (SPP), clinical and radiographic peri-implant parameters, and biomarker levels among smokers and never smokers with and without peri-implantitis. Sixty individuals (20 smokers with peri-implantitis [group-1], 20 never smokers with peri-implantitis [group-2] and 20 never smokers without peri-implantitis [control-group]) were included. SPP was evaluated using a numeric pain rating scale (NPRS). Peri-implant plaque index (PI), probing depth (PD), and bleeding on probing (BOP) were recorded. After obtaining the samples, the levels of TNF-α, MMP-1, and IL-8 were measured. The mean SPP score in group-1, group-2, and the control group was 1.3 ± 1, 3.4 ± 1, and zero, respectively. The peri-implant mean PD (p < 0.05), BOP (p < 0.05), PI (p < 0.05), and crestal bone loss (CBL) (p < 0.05) were significantly higher among test groups than the control group. The levels of TNF-α, MMP-1, and IL-8 were significantly raised among group-1 and group-2 than the control group. A significant correlation between increasing SPP and PICF TNF-α, MMP-1, and IL-8 levels was observed based on regression analysis. Proinflammatory biomarkers were higher in smokers with peri-implantitis than never smokers with and without peri-implantitis, with a significant association between the proinflammatory cytokines and SPP.

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A Prospective, Randomized, Open-Label Study Comparing an Opioid-Sparing Postsurgical Pain Management Protocol With and Without Liposomal Bupivacaine for Full-Arch Implant Surgery

Cited by 20 publications

References 0 publications

A Retrospective Cross-Sectional Study of the Effect of Liposomal Bupivacaine on Postoperative Opioid Prescribing After Third Molar Extraction

A Retrospective Cross-Sectional Study of the Effect of Liposomal Bupivacaine on Postoperative Opioid Prescribing After Third Molar Extraction

Evolving Role of Liposomal Bupivacaine in Managing Post-Surgical Analgesia in Oral Surgery

Association of Self-Rated Pain with Clinical Peri-Implant Parameters and Cytokine Profile in Smokers and Never Smokers with and without Peri-Implantitis

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