Intraoperative Infiltration of Liposomal Bupivacaine vs Bupivacaine Hydrochloride for Pain Management in Primary Total Hip Arthroplasty: A Prospective Randomized Trial
Authors: Perets I, Walsh JP, Mu BH, Yuen LC, Ashberg L, Battaglia MR, Domb BG
Journal: J Arthroplasty. 2018 Feb;33(2):441–446
DOI: 10.1016/j.arth.2017.09.013
Background
Liposomal bupivacaine (LB) is promoted as a longer-acting anesthetic for periarticular infiltration in total hip arthroplasty (THA), but its benefit over standard bupivacaine is uncertain.
Methods
107 primary THA patients were randomized to LB + bupivacaine HCl vs bupivacaine HCl alone. Outcomes measured included opioid use, pain scores, ambulation, discharge timing, and side effects over 72 hours post-op.
Key Findings
No significant differences were observed between groups in pain, opioid consumption, ambulation, or discharge timing. No falls or adverse effect differences occurred.
Conclusions
Adding LB to bupivacaine does not improve early postoperative pain control or functional recovery after THA.
What Does This Mean for Providers?
Routine use of liposomal bupivacaine for periarticular infiltration during THA may not provide additional analgesic or recovery benefits within the first 72 hours post-op, suggesting reconsideration of its cost-effectiveness.