What question did this study set out to answer?

To compare postoperative opioid consumption and pain levels between an interscalene brachial plexus block and surgical-site infiltration of liposomal bupivacaine in patients undergoing shoulder arthroplasty.

April 5, 2017Journal of Bone and Joint Surgery

Randomized Controlled Trial of Interscalene Block Compared with Injectable Liposomal Bupivacaine in Shoulder Arthroplasty

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To compare postoperative opioid consumption and pain levels between an interscalene brachial plexus block and surgical-site infiltration of liposomal bupivacaine in patients undergoing shoulder arthroplasty.
Non-blinded randomized controlled trial of 156 patients undergoing primary shoulder arthroplasty.
Participants were randomized to receive either an interscalene brachial plexus blockade (n = 78) or intraoperative soft-tissue infiltration of bupivacaine liposome injectable suspension (n = 78).
Evaluated primary outcome of total morphine equivalent units consumed during the first 24 postoperative hours, alongside intraoperative narcotics and visual analog scale (VAS) pain scores at 0, 8, 16, and 24 hours.
Total postoperative opioid consumption over 24 hours was 14.8 ± 11.3 morphine equivalent units in the interscalene block group compared with 14.4 ± 16.8 units in the liposomal bupivacaine group (p = 0.849).
Intraoperative narcotic consumption was significantly lower in the interscalene block group (8.9 ± 4.1 morphine equivalent units) compared to the liposomal bupivacaine group (16.2 ± 7.0 morphine equivalent units; p < 0.001).
VAS pain scores were significantly lower with interscalene block at 0 hours (0.8 ± 2.2 vs 3.3 ± 2.7; p < 0.001) and 8 hours (1.4 ± 2.4 vs 3.2 ± 2.2; p < 0.001), similar at 16 hours (4.3 ± 2.8 vs 3.8 ± 2.4; p = 0.348), but significantly higher with interscalene block at 24 hours (4.9 ± 2.7 vs 3.9 ± 2.3; p = 0.021).

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Implication

Randomized trial finds equivalent 24-hour opioid consumption between interscalene block and liposomal bupivacaine in shoulder arthroplasty, suggesting early block benefits fade by 24 hours.

Cite This Study

Namdari et al. (2017) studied this question.

synapsesocial.com/papers/6a7444c64e109b88a161adb0 https://doi.org/10.2106/jbjs.16.00296

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Implication

Randomized trial finds equivalent 24-hour opioid consumption between interscalene block and liposomal bupivacaine in shoulder arthroplasty, suggesting early block benefits fade by 24 hours.

Randomized Controlled Trial of Interscalene Block Compared with Injectable Liposomal Bupivacaine in Shoulder Arthroplasty

Key Points

Discussion

Implication

Cite This Study

Randomized Controlled Trial of Interscalene Block Compared with Injectable Liposomal Bupivacaine in Shoulder Arthroplasty

Key Points

Discussion

Implication

Cite This Study

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