The use of liposomal bupivacaine in fracture surgery: a review

Author:

Gailey Andrew D.,Ostrum Robert F.

Abstract

AbstractHistorically, opioids have played a major role in the treatment of postoperative pain in orthopedic surgery. A multitude of adverse events have been associated with opioid use and alternative approaches to pain relief are being investigated, with particular focus on multimodal pain management regimens. Liposomal bupivacaine (EXPAREL) is a component of some multimodal regimens. This formulation of bupivacaine encapsulates the local anesthetic into a multivesicular liposome to theoretically deliver a consistent amount of drug for up to 72 hours. Although the use of liposomal bupivacaine has been studied in many areas of orthopedics, there is little evidence evaluating its use in patients with fractures. This systematic review of the available data identified a total of eight studies evaluating the use of liposomal bupivacaine in patients with fractures. Overall, these studies demonstrated mixed results. Three studies found no difference in postoperative pain scores on postoperative days 1–4, while two studies found significantly lower pain scores on the day of surgery. Three of the studies evaluated the quantity of narcotic consumption postoperatively and failed to find a significant difference between control groups and groups treated with liposomal bupivacaine. Further, significant variability in comparison groups and study designs made interpretation of the available data difficult. Given this lack of clear evidence, there is a need for prospective, randomized clinical trials focused on fully evaluating the use of liposomal bupivacaine in fracture patients. At present, clinicians should maintain a healthy skepticism and rely on their own interpretation of the available data before widely implementing the use of liposomal bupivacaine.

Publisher

Springer Science and Business Media LLC

Subject

Orthopedics and Sports Medicine,Surgery

Reference56 articles.

1. Number of all-listed procedures for discharges from short-stay hospitals, by procedure category and age: United States, 2010. Centers for Disease Control and Prevention. Published online 2010:2.

2. Brown CA, Starr AZ, Nunley JA. Analysis of Past Secular Trends of Hip Fractures and Predicted Number in the Future 2010–2050 | Ovid. Accessed Sept 9, 2019. https://oce-ovid-com.libproxy.lib.unc.edu/article/00005131-201202000-00009/HTML.

3. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030 | Ovid. J Bone Joint Surg. 2007;89(4):780–5.

4. Soffin EM, Waldman SA, Stack RJ, Liguori GA. An evidence-based approach to the prescription opioid epidemic in orthopedic surgery. Anest Analg. 2017;125(5):1704–13. https://doi.org/10.1213/ANE.0000000000002433.

5. Seymour RB, Ring D, Higgins T, Hsu JR. Leading the way to solutions to the opioid epidemic: AOA critical issues. J Bone Joint Surg Am. 2017;99(21):e113. https://doi.org/10.2106/JBJS.17.00066.

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