Current Practices for Multimodal Pain Management Using Liposomal Bupivacaine in Extracapsular and Intracapsular Hip...

Area of Science:

• Orthopaedic Surgery
• Pain Management
• Pharmacology

Background:

• Liposomal bupivacaine (LB) is effective in various surgeries but understudied in hip fracture pain management.
• Limited data exists on integrating LB into multimodal pain strategies for hip fractures.

Purpose of the Study:

• To develop consensus recommendations for using LB in hip fracture surgery.
• To establish multimodal, opioid-sparing pain management protocols for hip fractures.

Main Methods:

• A consensus statement was developed by orthopaedic surgeons and anesthesiologists.
• Discussions focused on local infiltration analgesia with LB for intracapsular and extracapsular hip fractures.
• The context was a multimodal, opioid-sparing pain management approach.

Main Results:

• Multimodal strategies are crucial for optimizing pain and minimizing opioids in hip fracture surgery.
• Intraoperative LB infiltration, pre-operative acetaminophen, NSAIDs, and tramadol are recommended.
• Postoperative pain management includes acetaminophen, NSAIDs, and opioid rescue as needed.

Conclusions:

• Consensus recommendations for multimodal pain management with LB in hip fracture surgery were established.
• These protocols provide a foundation for future research in hip fracture pain management.
• The recommendations address both intracapsular and extracapsular hip fracture procedures.