Liposomal vs Standard Bupivacaine in Supraclavicular Plexus Block .
Addition of Liposomal Bupivacaine to Standard Bupivacaine versus Standard Bupivacaine Alone in the Supraclavicular Brachial Plexus Block: A Randomized Controlled Trial.
Anesthesiology . 2024 Oct 1;141(4):732-744.Eighty patients undergoing distal radial fracture fixation were randomized to receive either a supraclavicular brachial plexus block with 10 ml 0.5% bupivacaine plus 10 ml 1.33% liposomal bupivacaine (n=40), or 20 ml 0.5% bupivacaine alone (n=40). The primary outcome was the weighted area under the curve (AUC) of numerical pain rating scores at rest over the first 48 hours postoperatively. Secondary outcomes included pain with movement, overall benefit of analgesia scores, opioid consumption, sleep quality, and recovery scores. Outcomes were assessed daily up to postoperative day 7, and at 2, 6, and 12 weeks postoperatively. Overall, the results revealed significantly lower pain scores at rest and with movement in the liposomal bupivacaine group on postoperative day 1, with no significant differences beyond that point. These findings suggest that liposomal bupivacaine modestly improves early postoperative pain but does not impact longer-term outcomes.
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