Liposomal Bupivacaine is NOT Better than Bupivacaine in Limited Incision Thoracic Surgery

Abstract

BACKGROUND: The prolonged bioavailability of liposomal bupivacaine suggests it might have a therapeutic advantage over bupivacaine in saline.  This is a retrospective analysis of limited incision thoracic surgery patients to evaluate if liposomal bupivacaine provided better pain control and altered outcomes compared to similar administration of bupivacaine in saline. This will give out a way to conduct future prospective randomized control trials to compare both LB and BS is superior to bupivacaine in saline. METHODS:  Study group patients were limited to those undergoing wedge or segmental resection or lobectomy via VATS or Robot Assisted approaches. Forty-four patients received liposomal bupivacaine (LB) while 63 patients who received bupivacaine in saline (BS). RESULTS:  For each group (LB v BS) the average length of stay (3.75 v 3.51 days), oral morphine equivalents (232 v 241 mg), and time to rescue narcotic dose (269 v 212 minutes) were not significantly different. CONCLUSIONS: Liposomal bupivacaine is considerably more expensive than bupivacaine in saline and did not demonstrate superior pain control and didn’t change clinical outcomes.