The Use of Liposomal Bupivacaine Administered With Standard Bupivacaine in Ankle Fractures Requiring Open Reduction Internal Fixation: A Single-Blinded Randomized Controlled Trial

Davidovitch, Roy I.; Goch, Abraham; Driesman, Adam; Konda, Sanjit R.; Pean, Christian A.; Egol, Kenneth A.

doi:10.1097/bot.0000000000000862

Cited by 26 publications

(21 citation statements)

References 27 publications

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“…The highest Cmax was observed in an individual taking the second dose 24 h after the first, but was below toxic levels for central nervous system and cardiac. In general, LB was well tolerated and revealed no clinically relevant unsafety signs (Rice et al 2017), provided excellent pain scores, lower opioids consumption, and at a lower cost (Mazloomdoost et al 2017;Sabesan et al 2017;Mcgraw-tatum et al 2017;Davidovitch et al 2017;Johnson et al 2017;Barron et al 2016). Thus, liposome formulation of the anesthetic rendered longer therapeutic times with no adverse effects.…”

Section: Pain Management: Bupivacainementioning

confidence: 87%

“…A slow-release mechanism involving reorganization of the barrier lipid membranes is sustained for up to 92 h with concomitant pain control for up to 72 h, as compared to 7-12 h with standard bupivacaine. Studies show bupivacaine decreased pain compared to placebo, the use of opioids and the hospital costs (Yeung et al 2018;Mazloomdoost et al 2017;Sabesan et al 2017;Declaire et al 2017;Smith et al 2017;Mcgraw-tatum et al 2017;Abildgaard et al 2017;Alijanipour et al 2016;Davidovitch et al 2017). Although the liposomal bupivacaine is not a nanoparticle (3-30 μm mean diameter), it is mentioned here because it is one of the most recent liposomal formulations approved.…”

Section: Pain Management: Bupivacainementioning

confidence: 99%

“…In a phase I trial with 47 patients showing refractory advanced solid tumors, MRX34 dosage (escalating twice-weekly) showed evidence of antitumor activity. In 2016, a phase I clinical trial of miRNA cancer therapy was carried out, in these study, 47 patients were treated twice a week with escalating doses of MRX34 IV (BAYER ® ) (Davidovitch et al 2017). MRX34 treatment with dexamethasone premedication was associated with acceptable safety indexes.…”

Section: Molecular Therapymentioning

confidence: 99%

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Nanomedicine review: clinical developments in liposomal applications

et al. 2019

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Background Many conventional drugs exhibit poor pharmacokinetics, limited bioavailability and a high toxicity, all of which restrain their use. To overcome these issues and improve the therapeutic indexes of the drug, the emergent fields of nanotechnology and nanomedicine have made significant progress in detection, diagnosis and treatment of several diseases at clinical level (Li et al. 2014; Yingchoncharoen et al. 2016; Signorell et al. 2018). In fact, thanks to nanoparticles and liposomes, it has been possible to decrease the toxicity and improve the pharmacokinetics parameters, such as distribution, increased circulation time, targeted controlled release, increased intracellular concentration, and

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Section: Pain Management: Bupivacainementioning

confidence: 87%

Section: Pain Management: Bupivacainementioning

confidence: 99%

Section: Molecular Therapymentioning

confidence: 99%

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Nanomedicine review: clinical developments in liposomal applications

et al. 2019

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“…32 In the trauma cohort, liposomal bupivacaine has been effective in lowering pain scores and decreasing narcotic use in patients undergoing ankle and distal radius surgeries. 33,34 The utility of liposomal bupivacaine in the geriatric hip fracture cohort has had limited investigation. Basmajian et al 35 studied liposomal bupivacaine versus a standardized oral pain control regimen in geriatric extracapsular hip fracture patients.…”

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confidence: 99%

Liposomal Bupivacaine Decreases Intravenous Opioid Use in Patients with Hip Fracture: A Modification to a Novel Pain Protocol

Stevenson

Stein

Fryhofer

et al. 2023

J Am Acad Orthop Surg

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Introduction:The aim of this study was to determine whether the administration of liposomal bupivacaine decreased opioid use and delirium in patients sustaining a hip fracture.Methods:A retrospective review of patients with hip fracture from September 2018 to October 2019 was performed through our institution's hip fracture registry. A liposomal bupivacaine cocktail was administered intraoperatively. Opioid requirement was determined for postoperative days 1, 2, and 3. Delirium was identified through chart review. Visual analog scale pain scores were averaged for postoperative days 1, 2, and 3. Four groups were analyzed: patients who received liposomal bupivacaine and IV acetaminophen, patients who only received IV acetaminophen, patients who only received liposomal bupivacaine, and control patients whose data were collected before this intervention. Continuous data were compared using a one-way analysis of variance or Student t-test, as applicable. Categorical data were compared using the Fisher exact test. Significance was set at P < 0.05.Results:One hundred nine patients met the inclusion criteria for the study with a mean age of 81.2 years. Eighty-two patients (75.2%) received intraoperative liposomal bupivacaine during the study year. Intravenous opioid requirement was markedly different among all four groups in all postoperative days. Oral opioid requirement and pain scores were not different between groups on any postoperative day. A notable decrease in IV opioid requirement in all postoperative days was seen in the Intervention groups (day 1 P < 0.001, day 2 P = 0.002, and day 3 P = 0.030). There existed a trend toward decreased delirium rates in the Intervention groups compared with the No Intervention group (23.9% vs. 32.8%, P = 0.272).Conclusion:The inclusion of liposomal bupivacaine in our institution's novel pain protocol led to notable decreases in opioid requirement in all postoperative days studied with a trend toward decreased delirium rates as well.

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“…10 Liposomal bupivacaine is a 72-hour slow-release anesthetic used frequently for orthopaedic and plastic surgery procedures and is associated with a reduced hospital length of stay (LOS). [12][13][14][15] Studies have shown the beneficial effects of liposomal bupivacaine for intercostal blocks during video-assisted thoracoscopic procedures, yet no study has evaluated this medication for intercostal nerve blocks in the treatment of traumatic rib fractures. 12 This study seeks to compare outcomes of epidural analgesia with intercostal nerve block using liposomal bupivacaine for the treatment of traumatic rib fractures.…”

mentioning

confidence: 99%

Intercostal Nerve Block with Liposomal Bupivacaine vs Epidural Analgesia for the Treatment of Traumatic Rib Fracture

Sheets

Davis

Dirks

et al. 2020

Journal of the American College of Surgeons

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BACKGROUND: Rib fractures are common among trauma patients and analgesia remains the cornerstone of treatment. Intercostal nerve blocks provide analgesia but are limited by the duration of the anesthetic. This study compares outcomes of epidural analgesia with intercostal nerve block using liposomal bupivacaine for the treatment of traumatic rib fractures. METHODS: A retrospective chart review was used to identify patients who received either epidural analgesia or intercostal nerve block with liposomal bupivacaine for the treatment of traumatic rib fractures. Patients were matched in a 1:1 ratio on age, Injury Severity Score, and number of rib fractures. Outcomes included intubations, mechanical ventilation days, ICU length of stay (LOS), hospital LOS, and mortality. RESULTS: After matching, 116 patients were included in the study. Patients receiving intercostal nerve blocks with liposomal bupivacaine were less likely to require intubation (3% vs 17%; p ¼ 0.015), had shorter hospital LOS (mean AE SD 8 AE 6 days vs 11 AE 9 days; p ¼ 0.020) and ICU LOS (mean AE SD 2 AE 5 days vs 5 AE 6 days; p ¼ 0.007). There were no differences in ventilator days or mortality. Minor complications occurred in 26% of patients that received an epidural catheter for rib fractures. No complications occurred in the patients receiving intercostal nerve block. CONCLUSIONS: Patients who received intercostal nerve blocks with liposomal bupivacaine required intubation less frequently and had shorter ICU and hospital LOS compared with epidural analgesia patients. These results suggest that intercostal nerve blocks with liposomal bupivacaine might be equal or superior to epidural analgesia.

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The Use of Liposomal Bupivacaine Administered With Standard Bupivacaine in Ankle Fractures Requiring Open Reduction Internal Fixation: A Single-Blinded Randomized Controlled Trial

Abstract: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 26 publications

References 27 publications

Nanomedicine review: clinical developments in liposomal applications

Nanomedicine review: clinical developments in liposomal applications

Liposomal Bupivacaine Decreases Intravenous Opioid Use in Patients with Hip Fracture: A Modification to a Novel Pain Protocol

Intercostal Nerve Block with Liposomal Bupivacaine vs Epidural Analgesia for the Treatment of Traumatic Rib Fracture

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