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Postoperative pain scores and opioid use after standard bupivacaine vs. liposomal bupivacaine regional blocks for abdominal cancer surgery: A propensity score matched study.
Boyev, Artem; Popat, Keyuri; Gottumukkala, Vijaya N R; Kwater, Andrzej P; Chiang, Yi-Ju; Prakash, Laura R; Newhook, Timothy E; Arvide, Elsa M; Dewhurst, Whitney L; Bruno, Morgan L; Van Meter, Antoinette; Hancher-Hodges, Shannon; Ghebremichael, Semhar; Williams, Uduak; Donahue, Hart; Soliz, Jose; Tzeng, Ching-Wei D.
Affiliation
  • Boyev A; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Popat K; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Gottumukkala VNR; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Kwater AP; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Chiang YJ; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Prakash LR; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Newhook TE; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Arvide EM; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Dewhurst WL; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Bruno ML; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Van Meter A; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Hancher-Hodges S; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Ghebremichael S; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Williams U; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Donahue H; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Soliz J; Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Tzeng CD; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: CDTzeng@mdanderson.org.
Am J Surg ; 237: 115770, 2024 Nov.
Article in En | MEDLINE | ID: mdl-38789322
ABSTRACT

BACKGROUND:

Fascial plane blocks (FPBs) are widely used for abdominal surgery with the assumption that liposomal bupivacaine (LB) is more effective than standard bupivacaine (SB).

METHODS:

This was a single-institution retrospective cohort study of patients administered FPBs with LB or SB â€‹+ â€‹admixtures (dexamethasone/dexmedetomidine) for open abdominal cancer surgery. Propensity score matching generated a 21 (LBSB) matched cohort. Opioid use (mg oral morphine equivalents, OME) and severe pain (≥3 pain scores ≥7 in a 24-h period) were compared.

RESULTS:

Opioid use was >150 â€‹mg OME in 19.9 â€‹% (29/146) LB and 16.4 â€‹% (12/73) SB patients (p â€‹= â€‹0.586). Severe pain was experienced by 44 â€‹% (64/146) LB and 53 â€‹% (39/73) SB patients (p â€‹= â€‹0.198). On multivariable analysis, SB vs LB choice was not associated with high opioid volume >150 â€‹mg or severe pain.

CONCLUSIONS:

FPBs with standard bupivacaine were not associated with higher 72-h opioid use or more severe pain compared to liposomal bupivacaine.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pain, Postoperative / Pain Measurement / Bupivacaine / Propensity Score / Analgesics, Opioid / Anesthetics, Local / Liposomes / Nerve Block Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Am J Surg Year: 2024 Type: Article Affiliation country: United States
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pain, Postoperative / Pain Measurement / Bupivacaine / Propensity Score / Analgesics, Opioid / Anesthetics, Local / Liposomes / Nerve Block Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Am J Surg Year: 2024 Type: Article Affiliation country: United States