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Brachial Plexus Block with Liposomal Bupivacaine for Shoulder Surgery Improves Analgesia and Reduces Opioid Consumption:Results from a Multicenter, Randomized, Double-Blind, Controlled Trial
- Source :
- Patel, M A, Gadsden, J C, Nedeljkovic, S S, Bao, X, Zeballos, J L, Yu, V, Ayad, S S & Bendtsen, T F 2020, ' Brachial Plexus Block with Liposomal Bupivacaine for Shoulder Surgery Improves Analgesia and Reduces Opioid Consumption : Results from a Multicenter, Randomized, Double-Blind, Controlled Trial ', Pain Medicine, vol. 21, no. 2, pp. 387-400 . https://doi.org/10.1093/pm/pnz103
- Publication Year :
- 2020
-
Abstract
- OBJECTIVE: The utility of single-injection and continuous peripheral nerve blocks is limited by short duration of analgesia and catheter-related complications, respectively. This double-blind, multicenter trial evaluated the efficacy, safety, and pharmacokinetics of single-injection, ultrasound-guided brachial plexus block (BPB) with liposomal bupivacaine (LB) added to a standardized pain management protocol for shoulder surgery. METHODS: Adults undergoing total shoulder arthroplasty or rotator cuff repair were randomized to receive LB 133 mg, LB 266 mg (pharmacokinetic and safety analyses only), or placebo, added to a standardized analgesia protocol. The primary end point was area under the curve (AUC) of visual analog scale pain intensity scores through 48 hours postsurgery. Secondary end points were total opioid consumption, percentage of opioid-free patients, and time to first opioid rescue through 48 hours. Pharmacokinetic samples were collected through 120 hours and on days 7 and 10. Adverse events were documented. RESULTS: One hundred fifty-five patients received treatment (LB 133 mg, N = 69; LB 266 mg, N = 15; placebo, N = 71). BPB with LB 133 mg was associated with significantly improved AUC of pain scores (least squares mean [SE] = 136.4 [12.09] vs 254.1 [11.77], P
- Subjects :
- Male
Shoulder
Shoulder surgery
medicine.medical_treatment
Opioid Analgesics
Placebo
03 medical and health sciences
0302 clinical medicine
Double-Blind Method
030202 anesthesiology
Multicenter trial
Local Anesthesia
Medicine
Humans
Pain Management
Local anesthesia
Orthopedic Procedures
Anesthetics, Local
Brachial plexus block
Aged
Bupivacaine
Pain, Postoperative
business.industry
Area under the curve
Nerve Block
General Medicine
Middle Aged
Brachial Plexus Block
Analgesics, Opioid
Anesthesiology and Pain Medicine
Anesthesia
Liposomes
Nerve block
Female
Neurology (clinical)
Analgesia
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Patel, M A, Gadsden, J C, Nedeljkovic, S S, Bao, X, Zeballos, J L, Yu, V, Ayad, S S & Bendtsen, T F 2020, ' Brachial Plexus Block with Liposomal Bupivacaine for Shoulder Surgery Improves Analgesia and Reduces Opioid Consumption : Results from a Multicenter, Randomized, Double-Blind, Controlled Trial ', Pain Medicine, vol. 21, no. 2, pp. 387-400 . https://doi.org/10.1093/pm/pnz103
- Accession number :
- edsair.doi.dedup.....eac6d50ba95b62cf87dc719555896080