Liposomal Bupivacaine Versus Bupivacaine Hydrochloride with Lidocaine during Midurethral Sling Placement: A Randomized Controlled Trial

Christopher Iwanoff, Charbel Salamon

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Study Objective: To study the effects of liposomal bupivacaine (LB) compared with bupivacaine hydrochloride with lidocaine on postoperative day 1 pain scores. Design: A randomized controlled trial (Canadian Task Force classification 1). Setting: An academic medical center within the department of female pelvic medicine and reconstructive surgery. Patients: Fifty-seven patients undergoing midurethral sling placement by a fellowship-trained urogynecologic surgeon and a fellow in female pelvic medicine and reconstructive surgery. Interventions: Fifty-seven patients were enrolled to participate in this study. There were 24 patients randomized to receive liposomal bupivacaine and 33 to receive a mixture of bupivacaine and lidocaine during the placement of a retropubic midurethral sling. Measurements and Main Results: Patients were given a diary of pain scales and asked to record their level of pain using the provided visual analog scale scored on a 100-mm Likert scale. Patients recorded their pain 4 hours after hospital discharge and on the night of surgery and their most intense pain each day thereafter for 7 days postoperatively. In addition, patients recorded total opioid and nonsteroidal anti-inflammatory drug consumption daily for 1 week postoperatively. Finally, the quality of recovery was assessed using the Quality of Recovery-15 (QoR-15) questionnaire scores. The median pain score in the experimental group was 20 mm (range, 0–80 mm) versus 30 mm (range, 0–60 mm) in the comparative group (p = .046). The postoperative day 1 QoR-15 scores were significantly lower in the LB group (124 [range, 54–150] vs 144 [range, 68–150], p = .007). There were no significant differences in opioid and nonsteroidal anti-inflammatory drug consumption, the remaining pain scores, or postoperative day 7 QoR-15 scores. Conclusion: The results suggest the use of liposomal bupivacaine during retropubic midurethral sling placement does not provide a clinically significant difference in postoperative day 1 pain scores when compared with immediate-acting bupivacaine hydrochloride and lidocaine.

Original languageEnglish (US)
Pages (from-to)1133-1138
Number of pages6
JournalJournal of Minimally Invasive Gynecology
Volume26
Issue number6
DOIs
StatePublished - Sep 1 2019

Fingerprint

Suburethral Slings
Bupivacaine
Lidocaine
Randomized Controlled Trials
Pain
Reconstructive Surgical Procedures
Opioid Analgesics
Anti-Inflammatory Agents
Medicine
Advisory Committees
Visual Analog Scale
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

@article{9e73ecc05ea44763888d759a918bdbaa,
title = "Liposomal Bupivacaine Versus Bupivacaine Hydrochloride with Lidocaine during Midurethral Sling Placement: A Randomized Controlled Trial",
abstract = "Study Objective: To study the effects of liposomal bupivacaine (LB) compared with bupivacaine hydrochloride with lidocaine on postoperative day 1 pain scores. Design: A randomized controlled trial (Canadian Task Force classification 1). Setting: An academic medical center within the department of female pelvic medicine and reconstructive surgery. Patients: Fifty-seven patients undergoing midurethral sling placement by a fellowship-trained urogynecologic surgeon and a fellow in female pelvic medicine and reconstructive surgery. Interventions: Fifty-seven patients were enrolled to participate in this study. There were 24 patients randomized to receive liposomal bupivacaine and 33 to receive a mixture of bupivacaine and lidocaine during the placement of a retropubic midurethral sling. Measurements and Main Results: Patients were given a diary of pain scales and asked to record their level of pain using the provided visual analog scale scored on a 100-mm Likert scale. Patients recorded their pain 4 hours after hospital discharge and on the night of surgery and their most intense pain each day thereafter for 7 days postoperatively. In addition, patients recorded total opioid and nonsteroidal anti-inflammatory drug consumption daily for 1 week postoperatively. Finally, the quality of recovery was assessed using the Quality of Recovery-15 (QoR-15) questionnaire scores. The median pain score in the experimental group was 20 mm (range, 0–80 mm) versus 30 mm (range, 0–60 mm) in the comparative group (p = .046). The postoperative day 1 QoR-15 scores were significantly lower in the LB group (124 [range, 54–150] vs 144 [range, 68–150], p = .007). There were no significant differences in opioid and nonsteroidal anti-inflammatory drug consumption, the remaining pain scores, or postoperative day 7 QoR-15 scores. Conclusion: The results suggest the use of liposomal bupivacaine during retropubic midurethral sling placement does not provide a clinically significant difference in postoperative day 1 pain scores when compared with immediate-acting bupivacaine hydrochloride and lidocaine.",
author = "Christopher Iwanoff and Charbel Salamon",
year = "2019",
month = "9",
day = "1",
doi = "10.1016/j.jmig.2018.11.005",
language = "English (US)",
volume = "26",
pages = "1133--1138",
journal = "Journal of Minimally Invasive Gynecology",
issn = "1553-4650",
publisher = "Elsevier",
number = "6",

}

TY - JOUR

T1 - Liposomal Bupivacaine Versus Bupivacaine Hydrochloride with Lidocaine during Midurethral Sling Placement

T2 - A Randomized Controlled Trial

AU - Iwanoff, Christopher

AU - Salamon, Charbel

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Study Objective: To study the effects of liposomal bupivacaine (LB) compared with bupivacaine hydrochloride with lidocaine on postoperative day 1 pain scores. Design: A randomized controlled trial (Canadian Task Force classification 1). Setting: An academic medical center within the department of female pelvic medicine and reconstructive surgery. Patients: Fifty-seven patients undergoing midurethral sling placement by a fellowship-trained urogynecologic surgeon and a fellow in female pelvic medicine and reconstructive surgery. Interventions: Fifty-seven patients were enrolled to participate in this study. There were 24 patients randomized to receive liposomal bupivacaine and 33 to receive a mixture of bupivacaine and lidocaine during the placement of a retropubic midurethral sling. Measurements and Main Results: Patients were given a diary of pain scales and asked to record their level of pain using the provided visual analog scale scored on a 100-mm Likert scale. Patients recorded their pain 4 hours after hospital discharge and on the night of surgery and their most intense pain each day thereafter for 7 days postoperatively. In addition, patients recorded total opioid and nonsteroidal anti-inflammatory drug consumption daily for 1 week postoperatively. Finally, the quality of recovery was assessed using the Quality of Recovery-15 (QoR-15) questionnaire scores. The median pain score in the experimental group was 20 mm (range, 0–80 mm) versus 30 mm (range, 0–60 mm) in the comparative group (p = .046). The postoperative day 1 QoR-15 scores were significantly lower in the LB group (124 [range, 54–150] vs 144 [range, 68–150], p = .007). There were no significant differences in opioid and nonsteroidal anti-inflammatory drug consumption, the remaining pain scores, or postoperative day 7 QoR-15 scores. Conclusion: The results suggest the use of liposomal bupivacaine during retropubic midurethral sling placement does not provide a clinically significant difference in postoperative day 1 pain scores when compared with immediate-acting bupivacaine hydrochloride and lidocaine.

AB - Study Objective: To study the effects of liposomal bupivacaine (LB) compared with bupivacaine hydrochloride with lidocaine on postoperative day 1 pain scores. Design: A randomized controlled trial (Canadian Task Force classification 1). Setting: An academic medical center within the department of female pelvic medicine and reconstructive surgery. Patients: Fifty-seven patients undergoing midurethral sling placement by a fellowship-trained urogynecologic surgeon and a fellow in female pelvic medicine and reconstructive surgery. Interventions: Fifty-seven patients were enrolled to participate in this study. There were 24 patients randomized to receive liposomal bupivacaine and 33 to receive a mixture of bupivacaine and lidocaine during the placement of a retropubic midurethral sling. Measurements and Main Results: Patients were given a diary of pain scales and asked to record their level of pain using the provided visual analog scale scored on a 100-mm Likert scale. Patients recorded their pain 4 hours after hospital discharge and on the night of surgery and their most intense pain each day thereafter for 7 days postoperatively. In addition, patients recorded total opioid and nonsteroidal anti-inflammatory drug consumption daily for 1 week postoperatively. Finally, the quality of recovery was assessed using the Quality of Recovery-15 (QoR-15) questionnaire scores. The median pain score in the experimental group was 20 mm (range, 0–80 mm) versus 30 mm (range, 0–60 mm) in the comparative group (p = .046). The postoperative day 1 QoR-15 scores were significantly lower in the LB group (124 [range, 54–150] vs 144 [range, 68–150], p = .007). There were no significant differences in opioid and nonsteroidal anti-inflammatory drug consumption, the remaining pain scores, or postoperative day 7 QoR-15 scores. Conclusion: The results suggest the use of liposomal bupivacaine during retropubic midurethral sling placement does not provide a clinically significant difference in postoperative day 1 pain scores when compared with immediate-acting bupivacaine hydrochloride and lidocaine.

UR - http://www.scopus.com/inward/record.url?scp=85059437133&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059437133&partnerID=8YFLogxK

U2 - 10.1016/j.jmig.2018.11.005

DO - 10.1016/j.jmig.2018.11.005

M3 - Article

AN - SCOPUS:85059437133

VL - 26

SP - 1133

EP - 1138

JO - Journal of Minimally Invasive Gynecology

JF - Journal of Minimally Invasive Gynecology

SN - 1553-4650

IS - 6

ER -