Liposomal Bupivacaine: Market Penetration Versus Scientific Evidence. Issue 4 (December 2017) - Sah, Alexander P.
Abstract : Hip and knee replacement continue to be two of the most reliable surgical procedures in relieving pain. The number of joint replacements performed in the United States are expected to continue to increase exponentially. Shorter hospital stays and rapid recovery protocols require optimal pain management to allow early or outpatient discharges. Traditional pain protocols based on opioids are associated with adverse events and complications. Growing literature has shown that the use of opioids even in association with elective joint replacement can lead to abuse and chronic use. Periarticular injections have offered the potential for improved pain relief while avoiding systemic side effects. Liposomal bupivacaine has gained rapid interest and broad use, despite conflicting results in the literature. The balance of market penetration and scientific evidence before widespread use requires careful analysis of the available literature. This review summarizes the current studies of liposomal bupivacaine used in total joint replacement.