Background:

Liposomal bupivacaine (LB) is FDA-approved for administration into surgical sites for postsurgical analgesia. The liposomal formulation allows for sustained effects up to 72 hours.

Methods:

A retrospective study assessed patients undergoing lumbar interbody surgery. Visual analog scale (VAS) pain scores and amount of opioids consumed were recorded at 12-hour intervals for 72 hours post-operatively, as were patterns of discharge and hospital length of stay (LOS).

Results:

A total of 122 patients (97 LB versus 25 control group) were reviewed. Median LOS was shorter in the LB cohort compared to controls (1.94 versus 3.08 days, respectively; p=0.0043). When assessing the percentage of discharges between groups at 12-hour intervals, there were significantly more discharges in the LB cohort at 36-48 hours (p=0.0226), and no differences elsewhere. There was a decrease in intravenous opioids consumed at 48-60 hours in the LB cohort compared to controls (p=0.0494), a difference not detected at other time points or with oral or total opioids. Mean VAS scores were significantly higher in LB cohort compared to controls at 0-12 hours (5.2 versus 3.9, respectively; p=0.0079), but insignificantly different subsequently up to 72 hours. The LB cohort and controls were not significantly different in total amount of opioids consumed, overall pain scores, or with regards to how the opioid amount consumed or pain scores changed over time.

Conclusions:

The use of LB in lumbar interbody fusion decreases patients’ LOS but has little effect on reducing overall pain scores or opioid usage in the 72-hour post-operative hospital time period.