No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

Barrington, John W.; Emerson, Roger H.; Lovald, Scott; Lombardi, Adolph V.; Berend, Keith R.

doi:10.1007/s11999-016-4931-z

Cited by 55 publications

(51 citation statements)

References 87 publications

(92 reference statements)

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“…2). [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Four studies 7,13,15,18 compared other groups in addition to liposomal bupivacaine and traditional PAI, so we selected only the data related to liposomal bupivacaine and traditional PAI for analysis. Finally, nine RCTs and seven nRCTs were included in our review (►Table 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…There were 924 liposomal bupivacaine cases and 1,293 traditional PAI cases in the 16 included studies. In most studies, the mean age was between 60 and 70 years old, and was 69 years in the oldest group 15 and 48 years in the youngest group. 10 All studies reported the gender of the patients.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…A total of 373 males and 551 females underwent liposomal bupivacaine, while 465 males and 829 females underwent traditional PAI. Four studies 8,9,13,15 reported the TKA side, with 107 left legs and 97 right legs for liposomal bupivacaine versus 192 left legs and 169 right legs for traditional PAI. The drugs used for PAI included ropivacaine or bupivacaine, epinephrine, and one type of opiate such as morphine.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…The drugs used for PAI included ropivacaine or bupivacaine, epinephrine, and one type of opiate such as morphine. Ten studies 8,11,[13][14][15][16][17]19,20,22 used ropivacaine, six studies 7,9,10,14,18,21 used bupivacaine, and one study 12 used one of them (►Table 1). Notably, 10 studies 7-9,15,17-22 reported one or more of their authors have disclosed potential or pertinent con-flicts of interest, and almost all these studies were RCTs except one.…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

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A Meta-Analysis Comparing Liposomal Bupivacaine and Traditional Periarticular Injection for Pain Control after Total Knee Arthroplasty

et al. 2018

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Liposomal bupivacaine is a novel method for pain control after total knee arthroplasty (TKA), but recent studies showed no advantage for patients undergoing TKA compared with traditional periarticular injection (PAI). The purpose of this analysis was to compare the clinical outcomes between liposomal bupivacaine treatment and traditional PAI. We retrospectively reviewed data from 16 clinical trials in published databases from their inception to June 2017. The primary outcome was postoperative Visual Analogue Scale (VAS) score and secondary outcomes included opiate usage, narcotic consumption, range of motion, and length of stay. Nine randomized controlled trials and seven nonrandomized controlled trials involving 924 liposomal bupivacaine cases and 1,293 traditional PAI cases were eligible for inclusion in the meta-analysis. No differences were detected in most of the clinical outcomes, except for postoperative VAS within 12 hours and length of stay. This analysis showed that liposomal bupivacaine is not associated with significant improvement in postoperative pain control or other outcomes in TKA compared with PAI.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Section: Study Characteristics and Qualitymentioning

confidence: 99%

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A Meta-Analysis Comparing Liposomal Bupivacaine and Traditional Periarticular Injection for Pain Control after Total Knee Arthroplasty

et al. 2018

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“…The use of LB in Total Knee Arthroplasty (TKA) has been heavily investigated with studies demonstrating varying results. A few studies have demonstrated an efficacy of LB close to that of regional femoral blockade and others have shown that it can significantly decrease postoperative narcotic use, length of stay, and postoperative Visual Analog Scale (VAS) scores [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Although many studies have shown the potential advantages of its use, many other studies have exhibited no benefit of its use in TKA The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Gannon¹

2018

SCTI

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Efficacy of Liposomal Bupivacaine and Bupivacaine Hydrochloride vs Bupivacaine Hydrochloride Alone as a Periarticular Anesthetic for Patients Undergoing Knee Replacement

et al. 2022

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for the Study of Peri-Articular Anaesthetic for Replacement of the Knee (SPAARK) Study Group IMPORTANCE More than half of patients who undergo knee replacement surgery report substantial acute postoperative pain.OBJECTIVE To evaluate the efficacy and cost-effectiveness of periarticular liposomal bupivacaine for recovery and pain management after knee replacement. DESIGN, SETTING, AND PARTICIPANTSThis multicenter, patient-blinded, pragmatic, randomized clinical superiority trial involved 533 participants at 11 institutions within the National Health Service in England. Adults undergoing primary unilateral knee replacement for symptomatic end-stage osteoarthritis were enrolled between March 29, 2018, and February 29, 2020, and followed up for 1 year after surgery. Follow-up was completed March 1, 2021. A per-protocol analysis for each coprimary outcome was performed in addition to the main intention-to-treat analysis.INTERVENTIONS Two hundred sixty-six milligrams of liposomal bupivacaine admixed with 100 mg of bupivacaine hydrochloride compared with 100 mg of bupivacaine hydrochloride alone (control) administered by periarticular injection at the time of surgery. MAIN OUTCOME AND MEASURESThe coprimary outcomes were Quality of Recovery 40 (QoR-40) score at 72 hours and pain visual analog scale (VAS) score area under the curve (AUC) from 6 to 72 hours. Secondary outcomes included QoR-40 and mean pain VAS at days 0 (evening of surgery), 1, 2, and 3; cumulative opioid consumption for 72 hours; functional outcomes and quality of life at 6 weeks, 6 months, and 1 year; and cost-effectiveness for 1 year. Adverse events and serious adverse events up to 12 months after randomization were also assessed. RESULTS Among the 533 participants included in the analysis, the mean (SD) age was 69.0 (9.7) years; 287 patients were women (53.8%) and 246 were men (46.2%). Baseline characteristics were balanced between study groups. There was no difference between the liposomal bupivacaine and control groups in QoR-40 score at 72 hours (adjusted mean difference, 0.54 [97.5% CI, −2.05 to 3.13]; P = .64) or the pain VAS score AUC at 6 to 72 hours (−21.5 [97.5% CI, −46.8 to 3.8]; P = .06). Analyses of pain VAS and QoR-40 scores demonstrated only 1 statistically significant difference, with the liposomal bupivacaine arm having lower pain scores the evening of surgery (adjusted difference −0.54 [97.5% CI, −1.07 to −0.02]; P = .02). No difference in cumulative opioid consumption and functional outcomes was detected. Liposomal bupivacaine was not cost-effective compared with the control treatment. No difference in adverse or serious adverse events was found between the liposomal bupivacaine and control groups.CONCLUSIONS AND RELEVANCE This study found no difference in postoperative recovery or pain associated with the use of periarticular liposomal bupivacaine compared with bupivacaine hydrochloride alone in patients who underwent knee replacement surgery.

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No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

Cited by 55 publications

References 87 publications

A Meta-Analysis Comparing Liposomal Bupivacaine and Traditional Periarticular Injection for Pain Control after Total Knee Arthroplasty

A Meta-Analysis Comparing Liposomal Bupivacaine and Traditional Periarticular Injection for Pain Control after Total Knee Arthroplasty

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Efficacy of Liposomal Bupivacaine and Bupivacaine Hydrochloride vs Bupivacaine Hydrochloride Alone as a Periarticular Anesthetic for Patients Undergoing Knee Replacement

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