A new study published in Journal of Neurosurgery: Spine examines liposomal bupivacaine use during posterior spinal decompression procedures.
The study authors examined 531 consecutive cases from October 2013 to February 2015 with 52 patients undergoing cervical procedures and 64 undergoing lumbar procedures. Both groups include patients who received bupivacaine hydrochloride and those who received liposomal bupivacaine. The researchers found:
1. The patients who received bupivacaine hydrochloride required twice the morphine when compared with the liposomal bupivacaine.
2. Intravenous rescue analgesic was greater in the bupivacaine hydrochloride patients for both the cervical and lumbar spine cohorts.
3. There wasn’t any difference in length of stay, complication or infection rates.
4. Among the chronic opioid users, there was a trend toward higher opiate for the bupivacaine hydrochloride group than the liposomal bupivacaine group. Among the patients who were opiate-naïve there wasn’t a difference in opiate requirements.
5. The liposomal bupivacaine didn’t significantly decrease the perioperative narcotic use or hospitalization length, concluded the study abstract.
“While the results of this study do not support the routine use of liposomal bupivacaine, there may be a benefit in the subgroup of patients who are chronic opioid users,” concluded the study authors.