Liposomal Bupivacaine for Pain Control After Rotator Cuff Repair
| Status: | Completed |
|---|---|
| Conditions: | Post-Surgical Pain, Orthopedic |
| Therapuetic Areas: | Musculoskeletal, Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/4/2018 |
| Start Date: | February 1, 2017 |
| End Date: | September 1, 2018 |
Liposomal Bupivacaine Reduces Opiate Consumption After Rotator Cuff Repair in a Randomized Control Trial
The use of an interscalene block (ISB) is often associated with rebound pain that could be
avoided through adjunctive therapy with longer duration. Administration of a liposomal
bupivacaine (LB) field block in addition to ISB would overcome this rebound pain to provide
greater pain relief and reduce opiate consumption when compared to ISB alone. 50 patients
were recruited and randomized into groups that either received or did not receive an
intraoperative LB field block in addition to standard ISB administration. Visual Analog Scale
(VAS) pain scores and narcotic consumption were recorded over the five-day postoperative
period to determine the effectiveness of LB pain relief.
avoided through adjunctive therapy with longer duration. Administration of a liposomal
bupivacaine (LB) field block in addition to ISB would overcome this rebound pain to provide
greater pain relief and reduce opiate consumption when compared to ISB alone. 50 patients
were recruited and randomized into groups that either received or did not receive an
intraoperative LB field block in addition to standard ISB administration. Visual Analog Scale
(VAS) pain scores and narcotic consumption were recorded over the five-day postoperative
period to determine the effectiveness of LB pain relief.
Arthroscopic rotator cuff repair (ARCR) provides excellent clinical outcomes but is often
associated with significant postoperative pain. As rotator cuff repair procedures become
increasingly more common, these procedures and the narcotic prescriptions which accompany
them may contribute to the rising opioid epidemic. The use of intraoperative local and
regional anesthesia or field blocks, in conjunction with multimodal pharmacological
strategies, is a widely accepted approach for managing surgical pain and reducing opiate use.
The purpose of this study was to determine whether using a field block of liposomal
bupivacaine (LB) in addition to an interscalene block (ISB) would provide greater pain relief
and reduction in opiate consumption when compared to ISB alone.
The study enrolled 50 patients undergoing primary ARCR surgery. Patients were randomized to
receiving intraoperative liposomal bupivacaine or not and provided with postoperative "Pain
Journals" to document their daily pain on a visual analog scale (VAS) and to track their
daily opioid consumption during the first five post-operative days.
associated with significant postoperative pain. As rotator cuff repair procedures become
increasingly more common, these procedures and the narcotic prescriptions which accompany
them may contribute to the rising opioid epidemic. The use of intraoperative local and
regional anesthesia or field blocks, in conjunction with multimodal pharmacological
strategies, is a widely accepted approach for managing surgical pain and reducing opiate use.
The purpose of this study was to determine whether using a field block of liposomal
bupivacaine (LB) in addition to an interscalene block (ISB) would provide greater pain relief
and reduction in opiate consumption when compared to ISB alone.
The study enrolled 50 patients undergoing primary ARCR surgery. Patients were randomized to
receiving intraoperative liposomal bupivacaine or not and provided with postoperative "Pain
Journals" to document their daily pain on a visual analog scale (VAS) and to track their
daily opioid consumption during the first five post-operative days.
Inclusion Criteria:
- at least 18 years of age
- undergoing an arthroscopic rotator cuff repair surgery of a full thickness tear
- willing to fill out the "Pain Journal"; able to understand the informed consent
process
- willing to document informed consent prior to completion of any study-related
procedure
- able to read, comprehend, and complete subject-reported outcome measures in English
Exclusion Criteria:
- pregnant
- documented history of drug or alcohol abuse
- use of narcotic painkillers greater than 3 months prior to surgery
- neurologic deficit or disability involving the surgical extremity
- known allergy or intolerance to hydrocodone or oxycodone
- known allergy to amide anesthetics
- currently enrolled or planning to enroll in another clinical trial during this study
that would affect the outcome of this study
- history of cognitive or mental health status that interferes with study participation
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