PMID- 30984490
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2192-5682 (Print)
IS  - 2192-5690 (Electronic)
IS  - 2192-5682 (Linking)
VI  - 9
IP  - 2
DP  - 2019 Apr
TI  - Can Liposomal Bupivacaine Be Safely Utilized in Elective Spine Surgery?
PG  - 133-137
LID - 10.1177/2192568218755684 [doi]
AB  - STUDY DESIGN: Single-blinded prospective randomized control trial. OBJECTIVES: To 
      compare the incidence of adverse events (AEs) and hospital length of stay between 
      patients who received liposomal bupivacaine (LB) versus a single saline 
      injection, following posterior lumbar decompression and fusion surgery for 
      degenerative spondylosis. METHODS: From 2015 to 2016, 59 patients undergoing 
      posterior lumbar decompression and fusion surgery were prospectively enrolled and 
      randomized to receive either 60 mL injection of 266 mg LB or 60 mL of 0.9% 
      sterile saline, intraoperatively. Outcome measures included the incidence of 
      postoperative AEs and hospital length of stay. RESULTS: The most common AEs in 
      the treatment group were nausea (39.3%), emesis (18.1%), and hypotension (18.1%). 
      Nausea (23%), constipation (19.2%), and urinary retention (15.3%) were most 
      common in the control group. Patients who received LB had an increased risk of 
      developing nausea (relative risk [RR] = 1.7; 95% confidence interval [CI] = 
      0.75-3.8), emesis (RR = 2.3; 95% CI = 0.51-10.7), and headaches (RR = 2.36; 95% 
      CI = 0.26-21.4). Patients receiving LB had a decreased risk of developing 
      constipation (RR = 0.78; 95% CI = 0.25-2.43), urinary retention (RR = 0.78; 95% 
      CI = 0.21-2.85), and pruritus (RR = 0.78; 95% = 0.21-2.8) postoperatively. 
      Relative risk values mentioned above failed to reach statistical significance. No 
      significant difference in the hospital length of stay between both groups was 
      found (3.9 vs 3.9 days; P = .92). CONCLUSION: Single-dose injections of LB to the 
      surgical site prior to wound closure did not significantly increase or decrease 
      the incidence or risk of developing AEs postoperatively. Furthermore, no 
      significant difference was found in the hospital length of stay between both 
      groups.
FAU - Brown, Luke
AU  - Brown L
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Weir, Tristan
AU  - Weir T
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Koenig, Scott
AU  - Koenig S
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Shasti, Mark
AU  - Shasti M
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Yousaf, Imran
AU  - Yousaf I
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Yousaf, Omer
AU  - Yousaf O
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Tannous, Oliver
AU  - Tannous O
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Koh, Eugene
AU  - Koh E
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Banagan, Kelley
AU  - Banagan K
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Gelb, Daniel
AU  - Gelb D
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Ludwig, Steven
AU  - Ludwig S
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
LA  - eng
PT  - Journal Article
DEP - 20180731
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC6448202
OTO - NOTNLM
OT  - adverse events
OT  - degenerative spondylosis
OT  - liposomal bupivacaine
OT  - lumbar decompression and fusion
OT  - opioid
OT  - postoperative pain
OT  - safety
COIS- Declaration of Conflicting Interests: The author(s) declared the following 
      potential conflicts of interest with respect to the research, authorship, and/or 
      publication of this article: LB, TW, SK, MS, IY, OSY, OT: No disclosures. SL: 
      American Board of Orthopaedic Surgery, Inc: Board or committee member; American 
      Orthopaedic Association: Board or committee member; AO Spine North America Spine 
      Fellowship Support: Research support; ASIP, ISD: Stock or stock options; Cervical 
      Spine Research Society: Board or committee member; DePuy, A Johnson & Johnson 
      Company: IP royalties; Paid consultant; Paid presenter or speaker; Globus 
      Medical: Paid consultant; Research support; Journal of Spinal Disorders and 
      Techniques: Editorial or governing board; K2M spine: Research support; K2Medical: 
      Paid consultant; OMEGA: Research support; Pacira: Research support; SMISS: Board 
      or committee member; Synthes: Paid consultant; Paid presenter or speaker; Thieme, 
      QMP: Publishing royalties, financial, or material support. DG: Advanced Spinal 
      Intellectual Property: Stock or stock options; Depuy-Synthes Spine: IP royalties; 
      Paid presenter or speaker; Globus Medical: IP royalties. EK: Biomet: Paid 
      consultant; DePuy, A Johnson & Johnson Company: Paid presenter or speaker. KB: 
      K2M: Employee; Orthofix, Inc: Research support.
EDAT- 2019/04/16 06:00
MHDA- 2019/04/16 06:01
PMCR- 2018/07/31
CRDT- 2019/04/16 06:00
PHST- 2019/04/16 06:00 [entrez]
PHST- 2019/04/16 06:00 [pubmed]
PHST- 2019/04/16 06:01 [medline]
PHST- 2018/07/31 00:00 [pmc-release]
AID - 10.1177_2192568218755684 [pii]
AID - 10.1177/2192568218755684 [doi]
PST - ppublish
SO  - Global Spine J. 2019 Apr;9(2):133-137. doi: 10.1177/2192568218755684. Epub 2018 
      Jul 31.