Liposomal Bupivacaine Versus Bupivacaine Hydrochloride for Intercostal Nerve Blockade in Minimally Invasive Thoracic Surgery

Alessia Pedoto, Jovanka Noel, Bernard J Park, David Amar, Alessia Pedoto, Jovanka Noel, Bernard J Park, David Amar

Abstract

Objectives: The objective of this study was to compare the effects of liposomal bupivacaine (Lipo-B) and bupivacaine hydrochloride (B-HCl), in the presence of multimodal analgesia, on postoperative analgesia and opioid consumption in minimally invasive thoracic surgery (MITS) lobectomy.

Design: Retrospective observational cohort study.

Setting: Tertiary care cancer center.

Participants: A total of 60 patients who underwent MITS lobectomy and received intercostal nerve blockade (ICNB) with either 0.66% Lipo-B (n = 29) or 0.5% B-HCl (n = 31).

Interventions: All patients received intravenous patient-controlled analgesia for the first 12 hours postoperatively, followed by opioids and nonsteroidal anti-inflammatory drugs as needed.

Measurements and main results: Perioperative opioid and nonopioid consumption and pain scores were compared between groups at 12-hour intervals for the first 72 hours. Between the two groups, there were no statistically significant differences in demographic characteristics, intraoperative (p = 0.46) and postoperative opioid consumption, Richmond Agitation-Sedation Scale scores and pain scores upon postanesthesia care unit arrival and after four hours, length of postanesthesia care unit stay (p = 0.84), or length of hospital stay (p = 0.55). Both groups received intra- and postoperative multimodal analgesia.

Conclusions: In this cohort, no differences in opioid consumption or pain scores were observed in the immediate postoperative period following MITS lobectomy between patients given ICNB with Lipo-B and those given ICNB with B-HCl in the presence of multimodal analgesia.

Keywords: acute pain; intercostal nerve blockade; liposomal bupivacaine; minimally invasive thoracic surgery.

Conflict of interest statement

Conflict of Interest The authors declare no conflicts of interest.

Copyright © 2020 Elsevier Inc. All rights reserved.

Figures

Figure 1.
Figure 1.
CONSORT diagram for the study population.
Figure 2.
Figure 2.
Postoperative total morphine equivalents (intravenous plus oral) use at 12-h intervals for 72 h. B-HCl, bupivacaine hydrochloride; Lipo-B, liposomal bupivacaine.

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