Liposomal Bupivacaine Addition Versus Standard Bupivacaine Alone for Colorectal Surgery: A Randomized Controlled Trial

Abstract

Aim: This study evaluated use of liposomal bupivacaine (LB) versus standard bupivacaine (SB) alone in quadratus lumborum (QL) blocks for laparoscopic colorectal surgery. Materials & methods: In this prospective, randomized controlled trial, patients received QL1 blocks with either LB (40 ml 0.125% SB plus 20 ml of LB) or SB (60 ml of 0.25% SB) with 30 ml per side. Opioid usage, pain scores, side effects and other medications were recorded. Results: For 78 patients (38 LB; 40 SB), all parameters were similar between groups, except that the LB group had a higher 48 h need for metoclopramide. Conclusion: LB provided no analgesic benefit over SB alone for QL blocks.

Clinical Trials registration number: NCT03702621

Lay abstract

This study evaluated use of extended release bupivacaine (LB) versus standard bupivacaine (SB) alone in nerve blocks for laparoscopic colorectal surgery. Patients undergoing colorectal surgery received nerve blocks with either LB combined with SB, or SB alone. Opioid usage, pain scores, side effects and other medications were recorded. For 78 patients (38 LB + SB; 40 SB), all parameters were similar between groups, except that the LB group had a higher 48 h need for anti-nausea medication. LB provided no pain control benefit over SB alone for nerve blocks in colorectal surgery.

Keywords::

• block
• bupivacaine
• colorectal
• liposomal
• opioid usage
• pain scores
• quadratus lumborum
• regional analgesia

Author contributions

Y Yeap, J Wolfe, J Stewart, A McCutchan and G Chawla contributed to the conception or design of the work and acquisition, analysis or interpretation of data for the work. B Robb, B Holcomb and B Vickery contributed to the acquisition, analysis or interpretation of data for the work. All authors contributed to drafting the work or revising it critically for important intellectual content and final approval of the version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Acknowledgments

The authors acknowledge PF Castelluccio (Department of Biostatistics, Indiana University, Indianapolis, Indiana, USA) for assistance with statistics.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Medical writing, editing, reference management and data preparation support was provided by JS Renschler (Department of Anesthesia, Indiana University, Indianapolis, Indiana, USA) and was funded by Indiana University in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved. The authors state that they obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case report.

Data sharing statement

The authors certify that this manuscript reports original clinical trial data. Individual, de-identified participant data that underlie the results reported in this article (text, tables, figures) are available from the corresponding author following publication, including the clinical study report and study protocol.