To evaluate the feasibility of liposomal bupivacaine (LB) versus ropivacaine for local infiltration blocks in postoperative acute pain management following primary multilevel posterior spinal fusion. Adult patients scheduled for elective primary multilevel posterior spinal fusion were assigned to receive either multi-layer local infiltration of LB (20 ml, 266 mg) into the muscle, paravertebral fascia and subcutaneous layer or standard local infiltration block with 0.75% ropivacaine hydrochloride solution before suturing the wound to manage postoperative acute pain. The primary endpoint was total opioid consumption within 72 h postoperatively, measured as oral morphine equivalent (OME). Between March 19, 2024 and July 23, 2024, 20 patients were enrolled, of whom 10 were treated with LB and 10 with ropivacaine. The mean (SD) OME opioid consumption within 72 h after surgery was 11.4 (16.2) mg in the LB group versus 25.9 (31.1) mg in the ropivacaine group. Moreover, 30% of patients in the LB group developed postoperative opioid-free pain management. The mean AUC 0-72 of Numeric Rating Scale scores was 11.6 (14.7) in the LB group versus 38.6 (51.2) in the ropivacaine group at rest, and 49.6 (39.7) versus 90.0 (71.9) during movement. The other efficacy outcomes were generally similar between groups. The mean nausea and vomiting scores were 0.4 (0.5) in the LB group and 0.1 (0.3) in the ropivacaine group. No serious adverse events were reported. LB is a potential promising long-acting local anesthetic for acute pain management following primary multilevel posterior spinal fusion. Trial Registration Chinese Clinical Trial Registry; Identifier: ChiCTR2400079702; registered on January 10, 2024.
Liu et al. (Sat,) studied this question.