Does Liposomal Bupivacaine Reduce Postoperative Opioid Use in Tissue Expander Based Breast Reconstruction?

Area of Science:

• Plastic Surgery
• Anesthesiology
• Pain Management

Background:

• Postoperative opioid use in breast reconstruction presents significant side effects.
• Enhanced Recovery After Surgery (ERAS) protocols aim to minimize opioid consumption.
• Regional anesthetic blocks are a key component of ERAS protocols.

Purpose of the Study:

• To compare the effectiveness of Exparel versus Marcaine in reducing postoperative opioid use.
• To evaluate the impact of liposomal bupivacaine on pain management after breast reconstruction.

Main Methods:

• Retrospective study of 163 breast reconstruction patients (Jan 2019 - June 2022).
• Patients received either Marcaine or Exparel for regional anesthesia.
• Opioid prescriptions were tracked and converted to morphine equivalent doses (MED).

Main Results:

• Exparel group showed significantly lower opioid consumption (97.21 ± 81.77 MED) vs. Marcaine group (160.53 ± 150.58 MED).
• The Exparel group had fewer total opioid prescriptions (1.35 vs. 1.90).
• No significant differences noted based on breast reconstruction type.

Conclusions:

• Exparel significantly reduces postoperative opioid requirements compared to Marcaine in breast reconstruction.
• This finding supports Exparel's role in ERAS protocols for breast reconstruction.
• Utilizing Exparel may enhance patient recovery and mitigate opioid-related adverse events.