Thursday, February 17, 2022

Impact of Liposomal Bupivacaine on Post-Operative Pain and Opioid Usage in Thyroidectomy

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Ann Otol Rhinol Laryngol. 2022 Feb 16:34894221079095. doi: 10.1177/00034894221079095. Online ahead of print.

ABSTRACT

OBJECTIVES: Opioid analgesia has been integral in post-operative pain control for decades. The over-prescription of opioids, commonly in the surgical patient, has contributed to the current opioid epidemic. Liposomal bupivacaine (LB), a long-acting analgesia formulation, has demonstrated decreased post-operative pain and opioid requirements in patients treate d across multiple surgical subspecialties. The aims of this retrospective study are to assess post-operative pain and opioid use in patients who received LB at the time of thyroidectomy.

METHODS: A cohort-matched retrospective review of patients who underwent thyroidectomy by 2 surgeons between January 2010 and December 2019 was performed. Patients were divided into those that received LB intraoperatively and those that did not. Statistical analyses were performed using the Chi-square or Fisher's exact test, and 2-sample T-test or Wilcoxon rank sum test.

RESULTS: Of the 201 patients included in this study, 113 patients received LB and 88 did not. Patients who received LB had a lower median visual analog scale (VAS) pain score (2 vs 3, P = .2252), lower maximum VAS pain score (6 vs 7, P = .0898), were less likely to require opioid medications (73.5% vs 85.2%, P = .0434), and had a lower percentage of daily morphine milligram equivalent value � �45 (89.8% vs 95.3%, P = .1581) during the post-operative period when compared to those that did not.

CONCLUSION: This study suggests a role for incisional infiltration with LB for post-operative pain management in patients undergoing transcervical thyroidectomy. We report reduced post-operative pain scores and opioid analgesia requirements in patients who received LB.

PMID:35172629 | DOI:10.1177/00034894221079095

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