Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;11(6):896-902.
doi: 10.1177/2192568220931053. Epub 2020 Jun 22.

Does Local Administration of Liposomal Bupivacaine Reduce Pain and Narcotic Consumption in Adult Spinal Deformity Surgery?

Andrew S Chung  1 , Dennis Crandall  1   2 , Jan Revella  2 , Biodun Adeniyi  2 , Yu Hui H Chang  3 , Michael S Chang  1   2
Affiliations

Does Local Administration of Liposomal Bupivacaine Reduce Pain and Narcotic Consumption in Adult Spinal Deformity Surgery?

Andrew S Chung et al. Global Spine J. 2021 Jul.

Abstract

Study design: Retrospective cohort study.

Objective: To determine if local administration of liposomal bupivacaine (LB) reduces postoperative pain scores and narcotic use in spinal deformity patients.

Methods: Adult patients undergoing elective spinal fusion (7 or more levels) for scoliosis or kyphosis were selected for inclusion. Patients received either periincisional injections of combined liposomal and standard bupivacaine (n = 90, group L) or standard bupivacaine only (n = 69, group C). Perioperative pain scores (VAS [visual analogue scale]), opioid use, length of stay, functional outcome (ODI [Oswestry Disability Index]), and perioperative complications were recorded. No external funding was received for this study.

Results: A total of 159 patients met inclusion criteria (mean age was 54.2 years of age). No significant baseline demographic differences were noted between the 2 groups. Group L experienced slight improvements in pain control on postoperative day (POD) 1 (P = .02). No difference in pain scores were otherwise noted. Group L transitioned off of intravenous (IV) narcotics faster with 52.6% less IV use by POD3 (P = .03). No differences in total narcotic consumption, perioperative complications, lengths of stay, and functional outcome scores were otherwise noted between the 2 cohorts.

Conclusions: The use of LB in adult spinal deformity surgery does not appear to provide clinically important improvements in postoperative pain at the manufacturer's recommended dosage. Furthermore, while patients receiving LB may transition more quickly off of IV narcotics, this does not appear to translate into an overall decrease in narcotic consumption, hasten return of bowel function, or decrease hospital lengths of stay. Future prospective randomized control trials are warranted. The use of varying dosages of LB may also help further clarify the true efficacy of LB in the setting of spinal deformity surgery.

Keywords: adult; exparel; liposomal bupivacaine; multimodal; opioids; pain; spinal deformity.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Inpatient intravenous (IV) opioid consumption (expressed in morphine-equivalents).
Figure 2.
Figure 2.
Inpatient (PO) opioid consumption (expressed in morphine-equivalents).
Figure 3.
Figure 3.
Inpatient total opioid consumption (expressed in morphine-equivalents).
Figure 4.
Figure 4.
Inpatient pain scores.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ailon T, Scheer JK, Lafage V, et al. International Spine Study Group. Adult spinal deformity surgeons are unable to accurately predict postoperative spinal alignment using clinical judgment alone. Spine Deform. 2016;4:323–329. doi:10.1016/j.jspd.2016.02.003 - PubMed
    1. Liu S, Diebo BG, Henry JK, et al. The benefit of nonoperative treatment for adult spinal deformity: identifying predictors for reaching a minimal clinically important difference. Spine J. 2016;16:210–218. doi:10.1016/j.spinee.2015.10.043 - PubMed
    1. Riley MS, Bridwell KH, Lenke LG, Dalton J, Kelly MP. Health-related quality of life outcomes in complex adult spinal deformity surgery. J Neurosurg Spine. 2018;28:194–200. doi:10.3171/2017.6.SPINE17357 - PubMed
    1. Bess S, Line B, Fu KM, et al. The health impact of symptomatic adult spinal deformity: comparison of deformity types to United States population norms and chronic diseases. Spine (Phila Pa 1976). 2016;41:224–233. doi:10.1097/BRS.0000000000001202 - PMC - PubMed
    1. Transfeldt EE, Topp R, Mehbod AA, Winter RB. Surgical outcomes of decompression, decompression with limited fusion, and decompression with full curve fusion for degenerative scoliosis with radiculopathy. Spine (Phila Pa 1976). 2010;35:1872–1875. doi:10.1097/BRS.0b013e3181ce63a2 - PubMed

LinkOut - more resources