Vol 76: Liposome Bupivacaine for Postsurgical Analgesia in Adult Patients Undergoing Laparoscopic Colectomy: Results from Prospective Phase IV Sequential Cohort Studies Assessing Health Economic Outcomes☆.Report as inadecuate



 Vol 76: Liposome Bupivacaine for Postsurgical Analgesia in Adult Patients Undergoing Laparoscopic Colectomy: Results from Prospective Phase IV Sequential Cohort Studies Assessing Health Economic Outcomes☆.


Vol 76: Liposome Bupivacaine for Postsurgical Analgesia in Adult Patients Undergoing Laparoscopic Colectomy: Results from Prospective Phase IV Sequential Cohort Studies Assessing Health Economic Outcomes☆. - Download this document for free, or read online. Document in PDF available to download.

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This article is from Current Therapeutic Research, Clinical and Experimental, volume 76.AbstractBackground: Opioid-based postsurgical analgesia exposes patients undergoing laparoscopic colectomy to elevated risk for gastrointestinal motility problems and other opioid-related adverse events ORAEs. The purpose of our research was to investigate postsurgical outcomes, including opioid consumption, hospital length of stay, and ORAE risk associated with a multimodal analgesia regimen, employing a single administration of liposome bupivacaine as well as other analgesics that act by different mechanisms. Methods: We analyzed combined results from 6 Phase IV, prospective, single-center studies in which patients undergoing laparoscopic colectomy received opioid-based intravenous patient-controlled analgesia PCA or multimodal analgesia incorporating intraoperative administration of liposome bupivacaine. As-needed rescue therapy was available to all patients. Primary outcome measures were postsurgical opioid consumption, hospital length of stay, and hospitalization costs. Secondary measures included time to first rescue opioid use, patient satisfaction with analgesia assessed using a 5-point Likert scale, and ORAEs. Results: Eighty-two patients underwent laparoscopic colectomy and did not meet intraoperative exclusion criteria PCA n = 56; multimodal analgesia n = 26. Compared with the PCA group, the multimodal analgesia group had significantly lower mean total postsurgical opioid consumption 96 vs 32 mg, respectively; P 0.0001 and shorter median postsurgical hospital length of stay 3.0 vs 4.0 days; P = 0.0019. Geometric mean costs were $11,234 and $13,018 in the multimodal analgesia and PCA groups, respectively P = 0.2612. Median time to first rescue opioid use was longer in the multimodal analgesia group versus PCA group 1.1 hours vs 0.6 hours, respectively; P=0.0003. ORAEs were experienced by 41% of patients receiving intravenous opioid PCA and 8% of patients receiving multimodal analgesia P = 0.0019. Study limitations included use of an open-label, nonrandomized design; small population size; and the inability to isolate treatment-related effects specifically attributable to liposome bupivacaine. Conclusions: Compared with intravenous opioid PCA, a liposome bupivacaine-based multimodal analgesia regimen reduced postsurgical opioid use, hospital length of stay, and ORAEs, and may lead to improved postsurgical outcomes following laparoscopic colectomy.



Author: Candiotti, Keith A.; Sands, Laurence R.; Lee, Edward; Bergese, Sergio D.; Harzman, Alan E.; Marcet, Jorge; Kumar, Anjali S.; Haas, Eric

Source: https://archive.org/







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