Liposomal bupivacaine intercostal block placed under direct vision reduces morphine use in thoracic surgery

Thoracic epidural analgesia (TEA) and liposomal bupivacaine (LB) are two methods used for postoperative pain control after thoracic surgery. Some studies have compared LB to standard bupivacaine. However, data comparing the outcomes of LB to TEA after minimally invasive lung resection is limited. Th...

Full description

Saved in:
Bibliographic Details
Published in:Journal of thoracic disease 2024-02, Vol.16 (2), p.1161-1170
Main Authors: Singh, Anupama, McAllister, Miles, De León, Luis E, Kücükak, Suden, Rochefort, Matthew M, Mazzola, Emanuele, Maldonado, Luisa, Hartigan, Phillip M, Jaklitsch, Michael T, Swanson, Scott J, Bueno, Raphael, Deeb, Ashley L, Patil, Namrata
Format: Article
Language:English
Subjects:
Original
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Thoracic epidural analgesia (TEA) and liposomal bupivacaine (LB) are two methods used for postoperative pain control after thoracic surgery. Some studies have compared LB to standard bupivacaine. However, data comparing the outcomes of LB to TEA after minimally invasive lung resection is limited. Therefore, the objective of our study was to compare postoperative pain, opioid usage, and outcomes between patients who received TEA . LB. We conducted a retrospective chart review of patients who underwent minimally invasive lung resections over an 8-month period. Intraoperatively, patients received either LB under direct vision or a TEA. Pain scores were obtained in the post-anesthesia care unit (PACU) and at 12, 24, and 48 hours postoperatively. Morphine milligram equivalents (MMEs) were calculated at 24 and 48 hours postoperatively. Postoperative outcomes were then compared between groups. In total, 391 patients underwent minimally invasive lung resection: 236 (60%) wedge resections, 51 (13%) segmentectomies, and 104 (27%) lobectomies. Of these, 326 (83%) received LB intraoperatively. Fewer patients in the LB group experienced postoperative complications (18% . 34%, P=0.004). LB patients also had lower median pain scores at 24 (P=0.03) and 48 hours (P=0.001) postoperatively. There was no difference in MMEs at 24 hours (P=0.49). However, at 48 hours, patients who received LB required less narcotics (P=0.02). Median hospital length of stay (LOS) was significantly shorter in patients who received LB (2 . 4 days, P
ISSN:2072-1439
2077-6624
DOI:10.21037/jtd-23-1405