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Does Liposomal Bupivacaine Decrease Postoperative Opioid Use in Conjunction with an Enhanced Recovery After Bariatric

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Liposomal bupivacaine did not reduce opioid use in bariatric surgery patients. Enhanced recovery after surgery (ERAS) programs showed a trend toward lower opioid consumption, but results were not statistically significant.

Keywords:
Bariatric surgeryEnhanced recoveryEnhanced recovery after surgeryLiposomal bupivacaineMinimally invasive surgeryMultimodal pain managementOpioid epidemic

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Area of Science:

  • Bariatric Surgery
  • Pain Management
  • Pharmacology

Background:

  • The opioid crisis necessitates reducing postoperative opiate use.
  • Liposomal bupivacaine (LB) is evaluated for its potential to decrease opioid consumption.
  • This study examines LB's role before and after implementing a bariatric enhanced recovery after surgery (ERAS) program.

Purpose of the Study:

  • To assess the efficacy of liposomal bupivacaine in minimizing postoperative opioid requirements.
  • To compare opioid use with and without LB in bariatric surgery patients.
  • To evaluate the impact of an ERAS program on opioid use in conjunction with LB.

Main Methods:

  • A prospective, double-blind, randomized controlled trial was conducted.
  • 100 patients undergoing minimally invasive weight loss surgery were enrolled.
  • Outcomes measured included opioid consumption (MME/day), pain levels, hospital stay, and adverse events.

Main Results:

  • No significant difference in mean MME/day was found between the liposomal bupivacaine and plain bupivacaine groups.
  • Patients in the ERAS group showed a trend toward lower MME/day compared to the no-ERAS group (p=0.049).
  • Length of stay, pain scores, and adverse events did not differ significantly between groups.

Conclusions:

  • Liposomal bupivacaine did not significantly decrease postoperative opioid use in minimally invasive bariatric surgery.
  • The study did not find LB to be effective in reducing opioid use, even within an ERAS protocol.
  • Further research may be needed to explore alternative pain management strategies in bariatric surgery.