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Liposomal bupivacaine

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https://www.readbyqxmd.com/read/28192247/comparison-of-peri-articular-liposomal-bupivacaine-and-standard-bupivacaine-for-postsurgical-analgesia-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#1
REVIEW
Xi Wang, Lin Xiao, Zhiyuan Wang, Guanghui Zhao, Jianbing Ma
OBJECTIVE: This meta-analysis aimed to compare the efficacy and safety of intraoperative peri-articular liposomal bupivacaine and standard bupivacaine in patients undergoing total knee arthroplasty. METHODS: A systematic search was performed in Medline (1966-2016.9), PubMed (1966-2016.9), Embase (1980-2016.9), ScienceDirect (1985-2016.9) and the Cochrane Library. Only high-quality studies were selected. Meta-analysis was performed using Stata 11.0 software. RESULTS: Three randomized controlled trials (RCTs) and two non-randomized controlled trials (Non-RCTs), including 1214 patients met the inclusion criteria...
February 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28182826/the-learning-curve-associated-with-the-administration-of-intra-articular-liposomal-bupivacaine-for-total-knee-arthroplasty-a-pilot-study
#2
Anton Khlopas, Randa K Elmallah, Morad Chughtai, George A Yakubek, Mhamad Faour, Alison K Klika, Carlos A Higuera, Robert M Molloy, Michael A Mont
INTRODUCTION: Liposomal bupivacaine is a long-acting, local, injectable anesthetic that is used to potentially mitigate post-operative pain after total knee arthroplasty (TKA). In addition, it may reduce opioid use in the post-operative period and shorten lengths-of-stay (LOS). There have been mixed results in the literature with regards to its efficacy, which raises questions regarding the injection technique used. Therefore, we evaluated the learning curve associated with injection techniques prior to, and after, formal teaching...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28157791/addition-of-liposome-bupivacaine-to-bupivacaine-hcl-versus-bupivacaine-hcl-alone-for-interscalene-brachial-plexus-block-in-patients-having-major-shoulder-surgery
#3
Catherine Vandepitte, Max Kuroda, Richard Witvrouw, Ludwig Anne, Johan Bellemans, Kristoff Corten, Pascal Vanelderen, Dieter Mesotten, Ine Leunen, Micheline Heylen, Sam Van Boxstael, Monika Golebiewski, Marc Van de Velde, Nebojsa Nick Knezevic, Admir Hadzic
BACKGROUND AND OBJECTIVES: We examined whether liposome bupivacaine (Exparel) given in the interscalene brachial plexus block lowers pain in the setting of multimodal postoperative pain management for major shoulder surgery. METHODS: Fifty-two adult patients were randomized to receive either 5 mL of 0.25% bupivacaine HCl immediately followed by 10 mL of liposome bupivacaine 133 mg (n = 26) or 15 mL of 0.25% standard bupivacaine alone (n = 26) in interscalene brachial plexus block...
February 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28146271/liposomal-bupivacaine-infiltration-at-the-surgical-site-for-the-management-of-postoperative-pain
#4
REVIEW
Thomas W Hamilton, Vassilis Athanassoglou, Stephen Mellon, Louise H Strickland, Marialena Trivella, David Murray, Hemant G Pandit
BACKGROUND: Despite multi-modal analgesic techniques, acute postoperative pain remains an unmet health need, with up to three quarters of people undergoing surgery reporting significant pain. Liposomal bupivacaine is an analgesic consisting of bupivacaine hydrochloride encapsulated within multiple, non-concentric lipid bi-layers offering a novel method of sustained-release analgesia. OBJECTIVES: To assess the analgesic efficacy and adverse effects of liposomal bupivacaine infiltration at the surgical site for the management of postoperative pain...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28144162/thoracic-epidural-catheter-for-postoperative-pain-control-following-an-ineffective-transversus-abdominis-plane-block-using-liposome-bupivacaine
#5
Brian D Terrien, David Espinoza, Charles C Stehman, Gabriel A Rodriguez, Nicholas C Connolly
A 24-year-old female with a history of ulcerative colitis underwent colectomy. The patient received an ineffective transversus abdominis plane (TAP) block with liposome bupivacaine (Exparel) intraoperatively and was started on a hydromorphone patient-controlled analgesia 5 hours after the TAP block, which did not relieve her pain. A continuous thoracic epidural (CTE) was then placed after blood levels of bupivacaine were drawn, and the patient immediately experienced significant pain relief. The combined use of liposome bupivacaine and bupivacaine CTE infusion in the postoperative management of this patient demonstrated no safety concerns, provided excellent analgesia and plasma concentrations of bupivacaine remained far below toxic levels...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28120158/pharmacokinetic-profile-and-tolerability-of-liposomal-bupivacaine-following-a-repeated-dose-via-local-subcutaneous-infiltration-in-healthy-volunteers
#6
David Rice, Justin W Heil, Lukasz Biernat
BACKGROUND: Liposomal bupivacaine is indicated for administration into the surgical site to produce post-surgical analgesia. OBJECTIVES: The objectives of this study were to characterize the pharmacokinetic and safety profiles of liposomal bupivacaine following a repeated dose in healthy volunteers. METHODS: Healthy adults were assigned to receive liposomal bupivacaine via subcutaneous infiltration in a single 266 mg dose (cohort 1) or in two 266 mg doses, with the second dose given immediately, 24, 48, or 72 h after the first dose (cohorts 2-5)...
March 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#7
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28070147/liposomal-bupivacaine-in-total-hip-arthroplasty-do-the-results-justify-the-cost
#8
Jason A Beachler, Daniel M Kopolovich, Creighton C Tubb, Siraj A Sayeed
INTRODUCTION: Liposomal bupivacaine has a paucity of data regarding narcotic requirements and hospital length of stay in comparison to other peri-articular injections, specifically in the total hip arthroplasty (THA) population. METHODS: 69 patients who underwent THA by a single surgeon were divided into two cohorts over a 3 year period in this retrospective study comparing narcotic requirements, hospital length of stay and cost. The study group (n = 29) received liposomal bupivacaine whereas a matched control group (n = 40) received a pharmacy-mixed cocktail in peri-articular structures...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28059913/liposomal-bupivacaine-use-in-transversus-abdominis-plane-blocks-reduces-pain-and-postoperative-intravenous-opioid-requirement-after-colorectal-surgery
#9
Audrey L Stokes, Sanjib D Adhikary, Ashley Quintili, Frances J Puleo, Christine S Choi, Christopher S Hollenbeak, Evangelos Messaris
BACKGROUND: Enhanced recovery protocols frequently use multimodal postoperative analgesia to improve postoperative outcomes in patients undergoing colorectal surgery. OBJECTIVE: The purpose of this study was to evaluate liposomal bupivacaine use in transversus abdominis plane blocks on postoperative pain scores and opioid use after colorectal surgery. DESIGN: This was a retrospective cohort study comparing outcomes between patients receiving nonliposomal anesthetic (n = 104) and liposomal bupivacaine (n = 303) blocks...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28029532/role-of-periarticular-liposomal-bupivacaine-infiltration-in-patients-undergoing-total-knee-arthroplasty-a-meta-analysis-of-comparative-trials
#10
Preet Mohinder Singh, Anuradha Borle, Anjan Trikha, Lia Michos, Ashish Sinha, Basavana Goudra
BACKGROUND: Over last 2 years, many trials have evaluated newly approved liposomal bupivacaine for periarticular infiltration in total knee arthroplasty (TKA) with mixed results. Our meta-analysis attempts to consolidate the results and make evidence-based conclusions. METHODS: Trails comparing periarticular infiltration of liposomal bupivacaine to conventional analgesic regimens for total knee arthroplasty published till June 2016 were searched in medical database...
October 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28018759/could-the-use-of-an-enhanced-recovery-protocol-in-laparoscopic-donor-nephrectomy-be-an-incentive-for-live-kidney-donation
#11
Aparna Rege, Harold Leraas, Deepak Vikraman, Kadiyala Ravindra, Todd Brennan, Tim Miller, Julie Thacker, Debra Sudan
INTRODUCTION AND BACKGROUND: Gastrointestinal (GI) recovery after major abdominal surgery can be delayed from an ongoing need for narcotic analgesia thereby prolonging hospitalization. Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to facilitate early recovery after major surgery by maintaining preoperative body composition and physiological organ function and modifying the stress response induced by surgical exposure. Enhanced recovery programs (ERPs) in colorectal surgery have decreased the duration of postoperative ileus and the hospital stay while showing equivalent morbidity, mortality, and readmission rates in comparison to the traditional standard of care...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/28009223/development-of-an-enhanced-recovery-after-surgery-eras-approach-for-lumbar-spinal-fusion
#12
Michael Y Wang, Peng-Yuan Chang, Jay Grossman
OBJECTIVE Over the past decade, Enhancing Recovery After Surgery (ERAS) programs have been implemented throughout the world across multiple surgical disciplines. However, to date no spinal surgery equivalent has been described. In this report the authors review the development and implementation of a "fast track" surgical approach for lumbar fusion. METHODS The first 42 consecutive cases in which patients were treated with the new surgical procedure were reviewed. A combination of endoscopic decompression, expandable cage deployment, and percutaneous screw placement were performed with liposomal bupivacaine anesthesia to allow the surgery to be performed without general endotracheal anesthesia...
December 23, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28005125/the-role-of-liposomal-bupivacaine-in-value-based-care
#13
COMPARATIVE STUDY
Richard Iorio
Multimodal pain control strategies are crucial in reducing opioid use and delivering effective pain management to facilitate improved surgical outcomes. The utility of liposomal bupivacaine in enabling effective pain control in multimodal strategies has been demonstrated in several studies, but others have found the value of liposomal bupivacaine in such approaches to be insignificant. At New York University Langone Medical Center, liposomal bupivacaine injection and femoral nerve block were compared in their delivery of efficacious and cost-effective multimodal analgesia among patients undergoing total joint arthroplasty (TJA)...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28005122/opioid-sparing-pain-control-in-outpatient-total-joint-arthroplasty
#14
John W Barrington
Postoperative pain management is vital to promoting recovery and improving clinical outcomes. Although improved understanding of pain pathways has led to the development of varied approaches for controlling pain after surgery, some approaches are associated with potentially harmful side effects. Several lines of evidence have demonstrated that opioid analgesics can have unwanted adverse effects on patients having surgery. Similarly, risks associated with femoral nerve blocks have outweighed the benefits. Liposomal bupivacaine has shown efficacy in reducing the need for opioid analgesics and nerve blocks...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28005096/liposomal-bupivacaine-vs-interscalene-nerve-block-for-pain-control-after-shoulder-arthroplasty-a-retrospective-cohort-analysis
#15
COMPARATIVE STUDY
Casey V Hannan, Matthew J Albrecht, Steve A Petersen, Uma Srikumaran
The aim of this study was to compare liposomal bupivacaine and interscalene nerve block (ISNB) for analgesia after shoulder arthroplasty. We compared 37 patients who received liposomal bupivacaine vs 21 who received ISNB after shoulder arthroplasty by length of hospital stay (LOS), opioid consumption, and postoperative pain. Pain was the same in both groups for time intervals of 1 hour and 8 to 14 hours postoperatively. Compared with ISNB patients, liposomal bupivacaine patients reported less pain at 18 to 24 hours (P = ...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27999501/axillary-block-induced-chemical-sympathectomy-in-the-setting-of-digital-ischemia
#16
José R Soberón, T Michael Truxillo, Christin C Gethers, Taylor A Smith, William E Davis
BACKGROUND: Digital ischemia is associated with several rheumatologic disorders and is often difficult to treat. Symptoms and sequelae can include pain, disability, need for amputation, and poor quality of life. METHODS: Patients diagnosed with digital ischemia were referred for an ultrasound-guided axillary nerve block using liposomal bupivacaine (Exparel, Pacira Pharmaceuticals). The primary outcome measure was radial and ulnar artery diameter preprocedure and postprocedure...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27999499/perineural-liposomal-bupivacaine-for-postoperative-pain-control-in-patients-undergoing-upper-extremity-orthopedic-surgery-a-prospective-and-randomized-pilot-study
#17
José R Soberón, William Ericson-Neilsen, Leslie E Sisco-Wise, Mariella Gastañaduy, David E Beck
BACKGROUND: Upper extremity surgery is commonly performed in the ambulatory setting and is associated with moderate to severe postoperative pain. METHODS: Patients scheduled for upper extremity orthopedic surgery with a peripheral nerve block were randomized to receive either an ultrasound-guided single-injection supraclavicular block or ultrasound-guided median, ulnar, and radial nerve blocks (forearm blocks) performed at the level of the mid to proximal forearm with liposomal bupivacaine (Exparel) combined with a short-acting supraclavicular block...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27924842/effects-of-liposomes-charge-on-extending-sciatic-nerve-blockade-of-n-ethyl-bromide-of-lidocaine-in-rats
#18
Qinqin Yin, Bowen Ke, Xiaobing Chen, Yikai Guan, Ping Feng, Guo Chen, Yi Kang, Wensheng Zhang, Yu Nie
N-methyl bromide of lidocaine (QX-314) is a potential local anaesthetic with compromised penetration through cell membranes due to its obligated positive charge. Liposomes have been widely used for drug delivery with promising efficacy and safety. Therefore we investigated the local anaesthetic effects and tissue reactions of QX-314 in combination with anionic, cationic or neutral liposomes in rat sciatic nerve block model, and explored the effects of these liposomes on cellular entry of QX-314 in human embryonic kidney 293 cells...
December 7, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27909614/long-acting-liposomal-bupivacaine-decreases-inpatient-narcotic-requirements-in-men-undergoing-penile-prosthesis-implantation
#19
Brittney H Cotta, Charles Welliver, Anand Brahmamdam, Cynthia L Bednarchik, Danuta Dynda, Tobias S Köhler
OBJECTIVE: A new extended-release bupivacaine suspension bupivacaine (ERSB) delivers 3 days of local anesthetic and has been shown to reduce pain and narcotic usage in some patient groups but this issue is largely unstudied in urologic surgery. MATERIAL AND METHODS: We performed a single-surgeon retrospective chart review of the patients who underwent penile prosthesis implantation. Pain scores and standardized morphine equivalent (ME) dose data were collected during 23 hour- observation period...
December 2016: Turkish Journal of Urology
https://www.readbyqxmd.com/read/27856385/wound-infiltration-with-extended-release-versus-short-acting-bupivacaine-before-laparoscopic-hysterectomy-a-randomized-controlled-trial
#20
Kenneth I Barron, Georgine M Lamvu, R Cole Schmidt, Matthew Fisk, Emily Blanton, Insiyyah Patanwala
STUDY OBJECTIVE: To evaluate if pre-incision infiltration with extended-release liposomal bupivacaine provides improved overall pain relief compared to 0.25% bupivacaine after laparoscopic or robotic-assisted hysterectomy. DESIGN: Single center double-masked randomized controlled trial (Canadian Task Force Classification I). SETTING: Tertiary-care community hospital PATIENTS: Patients recruited from July 2015 through January 2016. Sixty-four patients were randomized and 59 were analyzed for the primary outcome...
November 14, 2016: Journal of Minimally Invasive Gynecology
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