According to a new study, researchers showed that Liposomal bupivacaine use in patients undergoing total knee arthroplasty is not associated with clinically meaningful reductions in inpatient opioid use, resource utilization, or opioid-related complications. The study was published online in Anesthesiology. Although some trials suggest benefits of liposomal bupivacaine, data on real-world use and effectiveness is lacking.

This study analyzed the impact of liposomal bupivacaine use (regardless of administration route) on inpatient opioid prescription, resource utilization, and opioid-related complications among patients undergoing total knee arthroplasties with a peripheral nerve block. It was hypothesized that liposomal bupivacaine has limited clinical influence on the studied outcomes.

Opioid

Researchers analyzed the impact of liposomal bupivacaine use (regardless of administration route) on inpatient opioid prescription, resource utilization, and opioid-related complications among 88,830 patients undergoing total knee arthroplasties (2013 to 2016) with a peripheral nerve block.

The researchers found that liposomal bupivacaine was used in 21.2% of patients. Its use was not associated with a clinically meaningful reduction in inpatient opioid prescription, length of stay, or cost of hospitalization. In addition, liposomal bupivacaine use was not associated with decreased odds of opioid-related complications.

Given the number of recent publications that suggest a lack of benefit of the addition of liposomal bupivacaine to a multimodal regimen, including a regional analgesic technique, its routine use should be carefully examined, especially given its relatively high cost.

Liposomal bupivacaine was not associated with a clinically relevant improvement in inpatient opioid prescription, resource utilization, or opioid-related complications in patients who received modern pain management including a peripheral nerve block.