학술논문
Sternotomy Wound Infiltration With Liposomal Versus Plain Bupivacaine for Postoperative Analgesia After Elective Cardiac Surgery.
Document Type
Academic Journal
Author
Subramaniam K; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA. Electronic address: subramaniamk@upmc.edu.; Sciortino CM; Sentara Mid-Atlantic Cardiothoracic Surgeons, Sentara Medical Group, Norfolk, VA.; Boisen ML; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA.; La Colla L; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA.; Dickson A; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA.; Nowakowski E; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA.; Prangley K; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA.; Ruppert KM; Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh, Pittsburgh PA.
Source
Publisher: W.B. Saunders Country of Publication: United States NLM ID: 9110208 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8422 (Electronic) Linking ISSN: 10530770 NLM ISO Abbreviation: J Cardiothorac Vasc Anesth Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: Poor pain control after cardiac surgery can be associated with postoperative complications, longer recovery, and development of chronic pain. The authors hypothesized that adding liposomal bupivacaine (LB) to plain bupivacaine (PB) will provide better and long-lasting analgesia when used for wound infiltration in median sternotomy.
Study Design: Prospective, randomized, and double-blinded clinical trial.
Setting: Single institution, tertiary care university hospital.
Participants: Adult patients who underwent elective cardiac surgery through median sternotomy.
Interventions: A single surgeon performed wound infiltration of LB plus PB or PB into the sternotomy wound, chest, and mediastinal tube sites.
Measurements and Main Results: Patients were followed up for 72 hours for pain scores, opioid consumption, and adverse events. Sixty patients completed the study for analysis (LB group [n = 29], PB group [n = 31]). Patient characteristics, procedural variables, and pain scores measured at specific intervals from 4 hours until 72 hours postoperatively did not reveal any significant differences between the groups. Mixed-model regression showed that the trend of mean pain scores at movement in the LB group was significantly (p = 0.01) lower compared with the PB group. Opioid consumption over 72 hours was not significantly different between the 2 groups (oral morphine equivalents; median [interquartile range], 139 [73, 212] mg in LB v 105 [54, 188] mg in PB, p = 0.29). Recovery characteristics and adverse events were comparable.
Conclusions: LB added to PB for sternotomy wound infiltration during elective cardiac surgery did not significantly improve the quality of postoperative analgesia.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Study Design: Prospective, randomized, and double-blinded clinical trial.
Setting: Single institution, tertiary care university hospital.
Participants: Adult patients who underwent elective cardiac surgery through median sternotomy.
Interventions: A single surgeon performed wound infiltration of LB plus PB or PB into the sternotomy wound, chest, and mediastinal tube sites.
Measurements and Main Results: Patients were followed up for 72 hours for pain scores, opioid consumption, and adverse events. Sixty patients completed the study for analysis (LB group [n = 29], PB group [n = 31]). Patient characteristics, procedural variables, and pain scores measured at specific intervals from 4 hours until 72 hours postoperatively did not reveal any significant differences between the groups. Mixed-model regression showed that the trend of mean pain scores at movement in the LB group was significantly (p = 0.01) lower compared with the PB group. Opioid consumption over 72 hours was not significantly different between the 2 groups (oral morphine equivalents; median [interquartile range], 139 [73, 212] mg in LB v 105 [54, 188] mg in PB, p = 0.29). Recovery characteristics and adverse events were comparable.
Conclusions: LB added to PB for sternotomy wound infiltration during elective cardiac surgery did not significantly improve the quality of postoperative analgesia.
(Copyright © 2022 Elsevier Inc. All rights reserved.)