The Efficacy and Safety of DepoFoam Bupivacaine in Patients Undergoing Bilateral, Cosmetic, Submuscular Augmentation Mammaplasty: A Randomized, Double-Blind, Active-Control Study

Smoot, John D.; Bergese, Sergio D.; Onel, Erol; Williams, Hayes T.; Hedden, William J.

doi:10.1177/1090820x11430831

Cited by 103 publications

(71 citation statements)

References 12 publications

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“…The development of a depot formulation of bupivacaine attempts to address this issue, as a liposomal formulation allows for the slow release of the local anesthetic over a period measured in days and not hours [67][68][69]. Although non-randomized, retrospective, unmasked studies have reported dramatic benefits of using liposome bupivacaine infiltration versus both a bupivacaine infusion or no local anesthetic involvement-such as decreasing hospitalization duration and pain scores 40-50% up to 24 hours postoperatively [70]-two randomized, bupivacaine HCl-controlled trials failed to detect any benefits apart from decreased opioid consumption through 48-60 hours [71,72]. Considering the lack of RCT-demonstrated benefits of liposome bupivacaine versus bupivacaine HCl combined with the 100-fold increase in cost of the former over the latter, it appears that additional data demonstrating analgesic or other benefits is warranted prior to widespread adoption of the new formulation.…”

Section: Liposome Bupivacainementioning

confidence: 99%

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

Cheng

2016

Pain Med

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Objective. To review the published evidence regarding perioperative analgesic techniques for breast cancer-related surgery.Design. Topical review.Methods. Randomized, controlled trials (RCTs) were selected for inclusion in the review. Also included were large prospective series providing estimates of potential risks and technical reports and small case series demonstrating a new technique or approaches of interest to clinicians.Results. A total of 514 abstracts were reviewed, with 284 studies meeting criteria for full review. The evidence regarding preemptive ketamine, scheduled opioids, perioperative non-steroidal anti-inflammatory drugs (NSAIDs), and intravenous lidocaine is mixed and deserves further investigation. There is strong evidence that both pregabalin and gabapentin provide analgesic benefits following breast surgery. There is minimal and conflicting data from highquality randomized, controlled studies suggesting that directly infiltrating and/or infusing local anesthetic (liposome encapsulated or unencapsulated) into the surgical wound is a reliably effective analgesic. In contrast, there is a plethora of data demonstrating the potent analgesia, opioid sparing, and decreased opioid-related side effects from thoracic epidural infusion and both single-injection and continuous paravertebral nerve blocks (the latter two demonstrating decreased persistent post-surgical pain between 2.5 and 12 months). Techniques with limited-yet promising-data deserving additional investigation include brachial plexus blocks, cervical epidural infusion, interfascial plane blocks, and interpleural blocks.Conclusions. While there are currently multiple promising analgesic techniques for surgical procedures of the breast that deserve further study, the only modalities demonstrated to provide potent, consistent perioperative pain control are thoracic epidural infusion and paravertebral nerve blocks.

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Section: Liposome Bupivacainementioning

confidence: 99%

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

Cheng

2016

Pain Med

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“…The structure of liposome bupivacaine allows for drug release over several days after administration into the surgical site 14,15 . In published prospective clinical studies in patients undergoing total knee arthroplasty 16 , hemorrhoidectomy 17,18 , breast augmentation 19 , or bunionectomy 20 , a single administration of liposome bupivacaine at the surgical site was well tolerated and associated with lower mean cumulative pain scores, comparable or less opioid consumption, and a comparable adverse event profile compared with bupivacaine HCl or placebo.…”

Section: Introductionmentioning

confidence: 97%

Assessment of liposome bupivacaine infiltration versus continuous femoral nerve block for postsurgical analgesia following total knee arthroplasty: a retrospective cohort study

Kirkness

Asche

Ren

et al. 2016

Current Medical Research and Opinion

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Objective: Perioperative pain management is an important aspect of recovery from total knee arthroplasty (TKA) because severe pain can delay ambulation and hospital discharge. The objective of this retrospective sequential cohort study was to determine the impact of local infiltration analgesia using liposome bupivacaine (Exparel 1 ) when compared with a continuous femoral nerve block (FNB) following TKA. . Significantly (p < 0.05) more patients in Group A (58%) and Group B (44%) walked on POD0 than in the control group (0%); almost all patients walked on POD1. The mean (SD) distance walked was also significantly greater (p < 0.05) on POD1 in Group A (193 [203]

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“…[15][16][17][18] However, its role in managing postoperative pain in patients undergoing spine surgery is not well understood. Due to the paucity of literature on this topic, the primary goal of this study is to determine the efficacy of LB following posterior lumbar decompression and fusion (PLDF) in a prospective, randomized placebo-controlled trial.…”

mentioning

confidence: 99%

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Brown¹,

Weir²,

Shasti³

et al. 2018

Int J Spine Surg

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Background: Postoperative pain management in spine surgery holds unique challenges. The purpose of this study is to determine if the local anesthetic liposomal bupivacaine (LB) reduces the total opioid requirement in the first 3 days following posterior lumbar decompression and fusion (PLDF) surgery for degenerative spondylosis.Methods: Fifty patients underwent PLDF surgery in a prospective randomized control pilot trial between August 2015 and October 2016 and were equally allocated to either a treatment (LB) or a control (saline) group. Assessments included the 72-hour postoperative opioid requirement normalized to 1 morphine milligram equivalent (MME), visual analog scale (VAS), and hospital length of stay.Results: LB did not significantly alter the 72-hour postoperative opioid requirement compared to saline (11.6 vs. 13.4 MME, P ¼ .40). In a subgroup analysis, there was also no significant difference in opioid consumption among narcotic-naive patients with either LB or saline. Among narcotic tolerant patients, however, opioid consumption was higher with saline than LB (20.6 MME vs. 13.3 MME, P ¼ .048). Additionally, pre-and postoperative VAS scores and hospital length of stay were not significantly different with either LB or saline.Conclusions: In the setting of PLDF surgery, LB injections did not significantly reduce the consumption of opioids in the first 3 postoperative days, nor did the hospital length of stay or VAS pain scores, compared to saline. However, LB could be beneficial in reducing the consumption of opioids in narcotic-tolerant populations.Level of Evidence: 2.

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The Efficacy and Safety of DepoFoam Bupivacaine in Patients Undergoing Bilateral, Cosmetic, Submuscular Augmentation Mammaplasty: A Randomized, Double-Blind, Active-Control Study

Abstract: DepoFoam bupivacaine trended toward benefit versus bupivacaine HCl on most efficacy measures. Due to early termination, the study was underpowered to achieve statistical significance.

Cited by 103 publications

References 12 publications

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

Assessment of liposome bupivacaine infiltration versus continuous femoral nerve block for postsurgical analgesia following total knee arthroplasty: a retrospective cohort study

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

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