Liposomal bupivacaine reduces narcotic use and time to flatus in a retrospective cohort of patients who underwent laparotomy

INTERNATIONAL JOURNAL OF SURGERY

卷:59

Article

Burnett, Atuhani^1,2  Faley, Brian¹  Nyirenda, Themba¹  Bamboat, Zubin M.¹ 

[1] Hackensack Univ Med Ctr, Dept Surg, Hackensack, NJ USA

[2] McGill Univ, Dept Oncol, 1001 Blvd Decarie, Montreal, PQ H4A 3J1, Canada

关键词: Exparel;    Liposomal bupivacaine;    Laparotomy;    Pain control;   

DOI  :  10.1016/j.ijsu.2018.09.018

来源: Elsevier

【 摘 要 】

Introduction: Sustained release liposomal bupivacaine (LB) is a new pain control option that can reduce opioid use after laparotomy, which is known to prolong ileus, length of stay. Methods: Sixty-one consecutive patients undergoing laparotomy were treated with a standardized multi-modal therapy (MMT) consisting of IV tylenol, toradol, and morphine/dilaudid PCA. Thirty-one of those patients were additionally treated with LB infiltrated during fascial closure. Endpoints were opioid use, time to flatus, length of stay, and complications. Results: Overall opioid use for 72 h was 78 mg of morphine for the MMT + LB group and 112 mg in the MMT control group (p = 0.04). During 0-24 h s PCA use was similar. However, during 24-48 h PCA use was decreased by 46% in the MMT + LB group (p = 0.038), and decreased by 55% during the 48-72 h period (p = 0.019). Time to flatus was decreased by 1.0 days in the MMT + LB group (p = 0.005). Conclusion: Use of LB in laparotomy patients decreases opioid use, time to flatus, and should be considered as a component of post-operative pain control.

【 授权许可】

Free