1107: EVALUATION OF LIPOSOMAL BUPIVACAINE VERSUS USUAL CARE AND ITS EFFECT ON PAIN FOR CARDIAC SURGERY

Abstract

Introduction: The objective of this study is to compare clinical effects of standard of care and liposomal bupivacaine. The primary outcome of this study will be to compare the pain scores associated with liposomal bupivacaine compared to standard of care of standard bupivacaine. Methods: A prospective, randomized, single-blinded, active-controlled, parallel group trial was conducted on cardiac surgery evaluating opioid analgesic consumption and effectiveness of pain control in patients who received liposomal bupivacaine vs. bupivacaine/epinephrine. The study was conducted at a 503-bed tertiary care community hospital. Participants included patients of at least 18 years of age undergoing a cardiac surgical procedure at the study institution. The standard of care group received 0.25% bupivacaine with epinephrine at 1 mL/kg total dose and the treatment arm received liposomal bupivacaine 266 mg/20 ml added to 40 ml 0.25% bupivacaine with epinephrine. Both treatment arms received either therapy as a single-dose infiltration from the first to the 8th intercostal space. Results: A total of 43 patients received liposomal bupivacaine and 44 patients received bupivacaine/epinephrine. The difference in average opioid (morphine equivalent) usage between liposomal bupivacaine and bupivacaine/epinephrine on post-operative (POD) day 1 was 11 mg (IQR 5.25-24.3 mg) and 14 mg (IQR 5-26.175 mg) and on POD 4, the difference was 1.5 mg (IQR 0-4.875) and 0 mg (IQR 0-3). There was no difference in average pain scores and adverse effects between the two groups. Conclusions: The results of this current study found that the administration of liposomal bupivacaine intra-operatively cardiac surgery show less opioid use as compared to the standard of care. The study is ongoing and enrolling more patients.