A prospective analysis describing the innovative use of liposomal bupivacaine in burn patients
| Autor: | Allison N. Boyd, Mary E. Blair, Kerri E. Degenkolb, Brett C. Hartman, Rajiv Sood, David R. Foster, Todd A. Walroth |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Population Critical Care and Intensive Care Medicine Transplant Donor Site Transplantation Autologous 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine medicine Humans Pain Management Prospective Studies Anesthetics Local Adverse effect education Pain Postoperative education.field_of_study business.industry Area under the curve 030208 emergency & critical care medicine Skin Transplantation General Medicine Length of Stay Middle Aged Pain management Liposomal Bupivacaine Bupivacaine Analgesics Opioid Treatment Outcome Case-Control Studies Anesthesia Liposomes Tissue and Organ Harvesting Emergency Medicine Morphine Female Surgery Observational study Burns business Total body surface area medicine.drug |
| Zdroj: | Burns. 46:370-376 |
| ISSN: | 0305-4179 |
| DOI: | 10.1016/j.burns.2019.07.031 |
| Popis: | Burn patients frequently require autograft harvesting to facilitate wound healing, often resulting in significant pain. Liposomal bupivacaine is indicated for administration into a surgical site to produce postsurgical analgesia. The objective of this study was to evaluate efficacy, safety, and duration of postoperative analgesia with liposomal bupivacaine for donor site pain in burn patients. This was an observational, case–control study including adult patients with 20% total body surface area (TBSA) burned who received liposomal bupivacaine for postoperative pain management after autograft harvesting from lower extremity donor site(s). Patients from the case group were matched to historical control patients treated with traditional pain management. The primary outcome was the cumulative pain scores on postoperative day one measured by the area under the curve (AUC0–24). Secondary outcomes included AUC0–72, total milligram morphine equivalents (MME), length of stay, and adverse events. Data were collected in 36 patients who received liposomal bupivacaine, with 21 patients eligible for matching to historical controls. Patients included in the intervention and control groups were well-matched at baseline. Patients in the intervention group had a significantly lower median (IQR) AUC0–24 [578 (408,740) vs. 680 (544,803); p = 0.05] and shorter length of stay [4 days (1,9.5) vs. 6 days (318); p = 0.01]. No differences in adverse events related to the administration of liposomal bupivacaine or opioid-related adverse events were observed. Results indicate liposomal bupivacaine is safe and effective in burn patients. The results of this study add to the limited body of literature examining efficacy in this population. |
| Databáze: | OpenAIRE |
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