Extended Release Liposomal Bupivacaine Injection (Exparel) for Early Postoperative Pain Control Following...

Area of Science:

• Pediatric Anesthesiology
• Craniofacial Surgery
• Pain Management

Background:

• Liposomal bupivacaine (LB) is a long-acting local anesthetic.
• Previous studies indicate LB reduces postoperative pain in adults.
• The safety and efficacy of LB in pediatric palatoplasty require further investigation.

Purpose of the Study:

• To evaluate the safety and effectiveness of liposomal bupivacaine in pediatric patients undergoing palatoplasty.
• To assess the impact of LB on postoperative pain, oral intake, and hospital stay duration.
• To determine the incidence of opioid use and adverse events associated with LB in this population.

Main Methods:

• Retrospective analysis of pediatric palatoplasty patients treated with intraoperative LB blocks.
• Data collected included FLACC pain scores, oral intake volume, opioid administration, and length of hospitalization.
• Patients received 1.3% LB as greater palatal nerve and surgical field blocks.

Main Results:

• Twenty-seven pediatric patients received LB with an average age of 10.8 months.
• Average FLACC pain scores were 2.4 in the PACU and 3.8 as inpatients.
• Patients tolerated oral intake at 10.3 hours postoperatively, with an average of 496.4 mL in 24 hours, and were discharged in 2.1 days.

Conclusions:

• Liposomal bupivacaine can be safely administered to pediatric patients undergoing palatoplasty.
• Intraoperative LB use is associated with reduced postoperative opioid requirements and facilitates early oral feeding.
• Further cost-effectiveness studies are warranted to establish the value of LB in pediatric plastic surgery.