Benefit of Liposomal Bupivacaine for Pain in TKA Questioned

No clinically relevant reduction in inpatient opioid use, costs for patients undergoing total knee arthroplasty.
No clinically relevant reduction in inpatient opioid use, costs for patients undergoing total knee arthroplasty.

HealthDay News — Liposomal bupivacaine use in patients undergoing total knee arthroplasty is not associated with clinically meaningful reductions in inpatient opioid use, resource utilization, or opioid-related complications, according to a study published online May 21 in Anesthesiology.

Lukas Pichler, MD, from Weill Cornell Medical College in New York City, and colleagues analyzed the impact of liposomal bupivacaine use (regardless of administration route) on inpatient opioid prescription, resource utilization, and opioid-related complications among 88,830 patients undergoing total knee arthroplasties (2013 to 2016) with a peripheral nerve block. 

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The researchers found that liposomal bupivacaine was used in 21.2% of patients. Its use was not associated with a clinically meaningful reduction in inpatient opioid prescription, length of stay, or cost of hospitalization. In addition, liposomal bupivacaine use was not associated with decreased odds of opioid-related complications.

"Given the number of recent publications that suggest a lack of benefit of the addition of liposomal bupivacaine to a multimodal regimen, including a regional analgesic technique, its routine use should be carefully examined, especially given its relatively high cost," the authors write.

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