Comparing bupivacaine alone to liposomal bupivacaine plus bupivacaine in interscalene blocks for total shoulder arthroplasty: a randomized, non-inferiority trial.

研究概要

Eighty patients undergoing total shoulder arthroplasty were included in this non-inferiority trial assessing the non-inferiority of bupivacaine (n=40) vs. liposomal bupivacaine plus bupivacaine (n=40) in interscalene brachial plexus block. The primary outcome of interest was 72-hour opioid consumption. Secondary outcomes of interest included opioid consumption, pain scores at rest, during activity, and worst pain score, acetaminophen and NSAID use, patient satisfaction, duration of sensory block, and block-related adverse events. The results found that bupivacaine could not demonstrate non-inferiority to liposomal bupivacaine plus bupivacaine for 72-hour opioid consumption. However, the difference was not clinically meaningful between groups, equating to 1.5 tablets of oxycodone over 3 days. 48-hour pain score, 72-hour opioid consumption, and block duration were significantly in favour of the liposomal bupivacaine group.