Category: Professional Posters
Purpose: Assess how liposomal bupivacaine administration postoperatively impacted opioid utilization, pain management, and length of hospital stay.
Methods: A retrospective chart review was conducted comparing patients who received liposomal bupivacaine (n=60) to patients receiving standard therapy (n=60) after TKA. Both treatment groups received the standard perioperative pain management protocols and postoperative physical therapy. The primary outcome of this study was comparing effectiveness of postoperative pain control by determining the total number of rescue postoperative oral/intravenous opioid doses and pain scale assessment on a range of 0 (no pain) to 10 (severe pain). The secondary outcome of this study was length of hospital stay
Results: The total number of rescue postoperative opioid doses in treatment group versus standard therapy group on the day of surgery, post-op day 1, and post-op day 2 were 267 vs. 322, 370 vs. 363, and 253 vs. 306, respectively. There was no statistically significant differences in total doses administered between groups (total dose: F= 1.71; P =0.194). The average minimum pain scale scores in the treatment group versus the standard therapy group were 5.46 vs. 5.58, 5.32 vs. 5.21, and 5.66 vs. 5.3, respectively. The average maximum pain scale scores were 7.55 vs. 8.06, 7.55 vs. 7.79, and 7.54 vs. 7.67, respectively. There were no patients discharged in the from the treatment group on post-op day 1, compared to 3 patients discharged in the standard therapy group. On post-op day 2, there was a decreased length of hospital stay in the treatment group with 12 patients discharged, compared to 6 patients discharged in the standard therapy group. There was no significant reduction in pain scales: average minimum pain scale score (F=1.71, P = 0.324) and average maximum pain scale score (F =0.048; P =0.824).
Conclusion: The use of postoperative opioids, reported pain scale scores, and overall hospital length of stay in patients receiving liposomal bupivacaine compared to standard therapy showed no significant reductions. More patients were discharged on post-op day 1 in the standard therapy group compared to patients receiving liposomal bupivacaine.