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    Can Liposomal Bupivacaine Be Safely Utilized in Elective Spine Surgery?

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    Author
    Brown, L.
    Weir, T.
    Koenig, S.
    Date
    2019
    Journal
    Global Spine Journal
    Publisher
    SAGE Publications Ltd
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1177/2192568218755684
    Abstract
    Study Design: Single-blinded prospective randomized control trial. Objectives: To compare the incidence of adverse events (AEs) and hospital length of stay between patients who received liposomal bupivacaine (LB) versus a single saline injection, following posterior lumbar decompression and fusion surgery for degenerative spondylosis. Methods: From 2015 to 2016, 59 patients undergoing posterior lumbar decompression and fusion surgery were prospectively enrolled and randomized to receive either 60 mL injection of 266 mg LB or 60 mL of 0.9% sterile saline, intraoperatively. Outcome measures included the incidence of postoperative AEs and hospital length of stay. Results: The most common AEs in the treatment group were nausea (39.3%), emesis (18.1%), and hypotension (18.1%). Nausea (23%), constipation (19.2%), and urinary retention (15.3%) were most common in the control group. Patients who received LB had an increased risk of developing nausea (relative risk [RR] = 1.7; 95% confidence interval [CI] = 0.75-3.8), emesis (RR = 2.3; 95% CI = 0.51-10.7), and headaches (RR = 2.36; 95% CI = 0.26-21.4). Patients receiving LB had a decreased risk of developing constipation (RR = 0.78; 95% CI = 0.25-2.43), urinary retention (RR = 0.78; 95% CI = 0.21-2.85), and pruritus (RR = 0.78; 95% = 0.21-2.8) postoperatively. Relative risk values mentioned above failed to reach statistical significance. No significant difference in the hospital length of stay between both groups was found (3.9 vs 3.9 days; P =.92). Conclusion: Single-dose injections of LB to the surgical site prior to wound closure did not significantly increase or decrease the incidence or risk of developing AEs postoperatively. Furthermore, no significant difference was found in the hospital length of stay between both groups. Copyright The Author(s) 2018.
    Keyword
    adverse events
    degenerative spondylosis
    liposomal bupivacaine
    lumbar decompression and fusion
    opioid
    postoperative pain
    safety
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85063618455&doi=10.1177%2f2192568218755684&partnerID=40&md5=04efe2e886850f57957cd7e32b9abdfa; http://hdl.handle.net/10713/10565
    ae974a485f413a2113503eed53cd6c53
    10.1177/2192568218755684
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