PMID- 28375752
OWN - NLM
STAT- MEDLINE
DCOM- 20180104
LR  - 20181202
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 33
IP  - 7
DP  - 2017 Jul
TI  - Local infiltration for postsurgical analgesia following total hip arthroplasty: a 
      comparison of liposomal bupivacaine to traditional bupivacaine.
PG  - 1283-1290
LID - 10.1080/03007995.2017.1314262 [doi]
AB  - OBJECTIVE: To assess postsurgical clinical and economic outcomes of patients who 
      received local infiltration containing liposomal bupivacaine versus traditional 
      bupivacaine for pain management following total hip arthroplasty (THA). METHODS: 
      This retrospective study included two groups of consecutive patients undergoing 
      THA. The experimental group received local infiltration with a combination of 
      liposomal bupivacaine, bupivacaine HCl 0.25% with epinephrine 1:200,000, and 
      ketorolac for postsurgical analgesia. The historical control group received the 
      previous standard of care: local infiltration with a combination of bupivacaine 
      HCl 0.25% with epinephrine 1:200,000 and ketorolac. Key outcomes included 
      distance walked, length of stay (LOS), opioid medication use, numeric pain 
      scores, hospital charges, hospital costs, all-cause 30 day readmission rate, and 
      adverse events (AEs). Both unadjusted and adjusted (i.e. age, sex, insurance 
      type, living situation, body mass index, procedure side, and comorbidity) 
      outcomes were compared between the two groups. RESULTS: The experimental group 
      (n = 64) demonstrated statistically significant improvement versus the historical 
      control group (n = 66) in mean distance walked on discharge day (249.2 vs. 180.0 
      feet; unadjusted p = .025, adjusted p = .070), mean LOS (2.0 vs. 2.7 days; 
      p < .001, p = .002), proportion of patients who used opioid rescue medication on 
      postoperative day (POD) 1 (29.7% vs. 56.1%; p = .002, p = .003) and POD 2 (7.8% 
      vs. 30.3%; p = .001, p = .003), mean cumulative area under the curve for pain 
      score on POD 0 (127.6 vs. 292.5; p < .001, both), POD 1 (92.9 vs. 185.0; 
      p < .001, both), and POD 2 (93.8 vs. 213.8; p = .006, both). Among a subgroup of 
      patients with available financial information, mean hospital charges were lower 
      in the experimental group ($43,794 [n = 24] vs. $48,010 [n = 66]; p < .001, 
      both). Rates of all-cause 30 day readmission and AEs were not significantly 
      different between groups. No falls occurred. CONCLUSIONS: Infiltration at the 
      surgical site with liposomal bupivacaine was associated with improved 
      postsurgical outcomes when compared with traditional bupivacaine in patients 
      undergoing THA.
FAU - Asche, Carl V
AU  - Asche CV
AD  - a Center for Outcomes Research, University of Illinois College of Medicine at 
      Peoria , Peoria , IL , USA.
AD  - b Department of Pharmacy Systems, Outcomes & Policy , University of Illinois at 
      Chicago College of Pharmacy , Chicago , IL , USA.
FAU - Ren, Jinma
AU  - Ren J
AD  - c University of Illinois College of Medicine at Peoria , Peoria , IL , USA.
FAU - Kim, Minchul
AU  - Kim M
AD  - c University of Illinois College of Medicine at Peoria , Peoria , IL , USA.
FAU - Gordon, Kate
AU  - Gordon K
AD  - d Unity Point-Proctor Hospital , Peoria , IL , USA.
FAU - McWhirter, Marie
AU  - McWhirter M
AD  - a Center for Outcomes Research, University of Illinois College of Medicine at 
      Peoria , Peoria , IL , USA.
FAU - Kirkness, Carmen S
AU  - Kirkness CS
AD  - a Center for Outcomes Research, University of Illinois College of Medicine at 
      Peoria , Peoria , IL , USA.
FAU - Maurer, Brian T
AU  - Maurer BT
AD  - e Great Plains Orthopaedics , Peoria , IL , USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20170428
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Anesthetics, Local)
RN  - 0 (Liposomes)
RN  - Y8335394RO (Bupivacaine)
SB  - IM
MH  - Aged
MH  - Analgesics, Opioid/therapeutic use
MH  - Anesthetics, Local/*administration & dosage/adverse effects
MH  - Arthroplasty, Replacement, Hip/*methods
MH  - Bupivacaine/*administration & dosage/adverse effects
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Liposomes
MH  - Male
MH  - Middle Aged
MH  - Pain, Postoperative/*drug therapy
MH  - Postoperative Period
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Analgesia
OT  - arthroplasty
OT  - hip
OT  - hospital charges
OT  - length of stay
OT  - pain
OT  - patient readmission
OT  - postoperative
OT  - recovery of function
OT  - replacement
EDAT- 2017/04/05 06:00
MHDA- 2018/01/05 06:00
CRDT- 2017/04/05 06:00
PHST- 2017/04/05 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
PHST- 2017/04/05 06:00 [entrez]
AID - 10.1080/03007995.2017.1314262 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2017 Jul;33(7):1283-1290. doi: 10.1080/03007995.2017.1314262. 
      Epub 2017 Apr 28.