Postoperative pain scores and opioid use after standard bupivacaine vs. liposomal bupivacaine regional blocks for abdominal cancer surgery: A propensity score matched study

Abstract

BackgroundFascial plane blocks (FPBs) are widely used for abdominal surgery with the assumption that liposomal bupivacaine (LB) is more effective than standard bupivacaine (SB). MethodsThis was a single-institution retrospective cohort study of patients administered FPBs with LB or SB ​+ ​admixtures (dexamethasone/dexmedetomidine) for open abdominal cancer surgery. Propensity score matching generated a 2:1 (LB:SB) matched cohort. Opioid use (mg oral morphine equivalents, OME) and severe pain (≥3 pain scores ≥7 in a 24-h period) were compared. ResultsOpioid use was >150 ​mg OME in 19.9 ​% (29/146) LB and 16.4 ​% (12/73) SB patients (p ​= ​0.586). Severe pain was experienced by 44 ​% (64/146) LB and 53 ​% (39/73) SB patients (p ​= ​0.198). On multivariable analysis, SB vs LB choice was not associated with high opioid volume >150 ​mg or severe pain. ConclusionsFPBs with standard bupivacaine were not associated with higher 72-h opioid use or more severe pain compared to liposomal bupivacaine.