Pain Management Efficacy Study Between Continuous and Single-Administration Bupivacaine Following Lumbar Spinal Fusion.

ABSTRACT

Poorly managed postoperative pain decreases patient satisfaction, impedes early patient mobilization, lengthens inpatient hospital stay, and increases healthcare costs. Multimodal analgesia with local anesthetics is considered most effective for postoperative pain management. This study compared patients undergoing lumbar fusion who received plain bupivacaine from May 2011 until August 2012 with those who received liposomal bupivacaine from September 2012 until May 2013. The aim was to determine which preparation reduced postoperative opioid use the most. All lumbar spinal fusion surgeries in the periods indicated were included in the study. Ninety-three patient charts were reviewed 47 for the plain bupivacaine group and 46 for the liposomal bupivacaine group. The study found no statistical difference between liposomal and plain bupivacaine in providing postoperative pain control from lumbar fusion surgery. Liposomal bupivacaine is as effective as plain bupivacaine for postoperative pain control after lumbar fusion. However, a continuous infusion system carries substantial inherent drawbacks need for training and setup, pump cost, risk of infection at the insertion site, or catheter migration. Therefore, liposomal bupivacaine becomes the logical and attractive choice to manage postoperative pain following lumbar fusion.