A prospective analysis describing the innovative use of liposomal bupivacaine in burn patients

Allison N. Boyd, Mary E. Blair, Kerri E. Degenkolb, David R. Foster, Brett C. Hartman, Rajiv Sood, Todd A. Walroth

Research output: Contribution to journalArticle

Abstract

Burn patients frequently require autograft harvesting to facilitate wound healing, often resulting in significant pain. Liposomal bupivacaine is indicated for administration into a surgical site to produce postsurgical analgesia. The objective of this study was to evaluate efficacy, safety, and duration of postoperative analgesia with liposomal bupivacaine for donor site pain in burn patients. This was an observational, case–control study including adult patients with <20% total body surface area (TBSA) burned who received liposomal bupivacaine for postoperative pain management after autograft harvesting from lower extremity donor site(s). Patients from the case group were matched to historical control patients treated with traditional pain management. The primary outcome was the cumulative pain scores on postoperative day one measured by the area under the curve (AUC0–24). Secondary outcomes included AUC0–72, total milligram morphine equivalents (MME), length of stay, and adverse events. Data were collected in 36 patients who received liposomal bupivacaine, with 21 patients eligible for matching to historical controls. Patients included in the intervention and control groups were well-matched at baseline. Patients in the intervention group had a significantly lower median (IQR) AUC0–24 [578 (408,740) vs. 680 (544,803); p = 0.05] and shorter length of stay [4 days (1,9.5) vs. 6 days (318); p = 0.01]. No differences in adverse events related to the administration of liposomal bupivacaine or opioid-related adverse events were observed. Results indicate liposomal bupivacaine is safe and effective in burn patients. The results of this study add to the limited body of literature examining efficacy in this population.

Original languageEnglish (US)
Pages (from-to)370-376
Number of pages7
JournalBurns
Volume46
Issue number2
DOIs
StatePublished - Mar 2020

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Keywords

  • Autograft
  • Burns
  • Donor site
  • Liposomal bupivacaine
  • Pain management

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Boyd, A. N., Blair, M. E., Degenkolb, K. E., Foster, D. R., Hartman, B. C., Sood, R., & Walroth, T. A. (2020). A prospective analysis describing the innovative use of liposomal bupivacaine in burn patients. Burns, 46(2), 370-376. https://doi.org/10.1016/j.burns.2019.07.031