title: Impact of liposome bupivacaine on the adequacy of pain management and patient experiences following aesthetic surgery: Results from an observational study.
abstract: BACKGROUND
  Despite the efficacy of opioid analgesics for postsurgical pain, they are associated with side effects that may complicate recovery. Liposome bupivacaine is a prolonged-release formulation of bupivacaine approved for intraoperative administration at the surgical site for postsurgical analgesia.
  
  
  OBJECTIVE
  To evaluate the effect of a single intraoperative administration of liposome bupivacaine on postsurgical pain, opioid use and opioid-related side effects in subjects undergoing breast surgery and/or abdominoplasty.
  
  
  METHODS
  In the present phase IV, multicentre, prospective observational study, subjects received a single intraoperative administration (266 mg) of liposome bupivacaine. Rescue analgesia was available to all subjects as needed. Outcome measures, assessed through postoperative day 3, included postsurgical pain intensity (11-point numerical rating scale), opioid consumption and overall benefit of analgesic score. Results were evaluated comparing investigators' previous experience with similar surgeries.
  
  
  RESULTS
  Forty-nine subjects entered the study: 34 underwent breast surgery only and 15 underwent abdominoplasty with or without breast surgery (six underwent breast surgery in addition to abdominoplasty). Mean numerical rating scale pain scores remained ≤4.3 from discharge through postoperative day 3. Median daily oral opioid consumption was approximately 1.0 tablet postoperatively on the day of surgery and was approximately 2.0 tablets by postoperative day 3. Mean overall benefit of analgesic score ranged between 2.8 and 4.9 throughout the study.
  
  
  CONCLUSIONS
  In this particular subject population, liposome bupivacaine was associated with low pain intensity scores and reduced opioid consumption compared with the investigators' previous experiences. Subjects' satisfaction with postsurgical analgesia was high, with a low burden of opioid-related side effects.
authors.affiliation: Edwards Plastic Surgery, Las Vegas, Nevada;
authors.forename: Michael C
authors.initials: MC
authors.lastname: Edwards
authors.affiliation: Delaware Valley Plastic Surgery, Cherry Hill, New Jersey;
authors.forename: Evan
authors.initials: E
authors.lastname: Sorokin
authors.affiliation: Plastic Surgery Group, Chattanooga, Tennessee;
authors.forename: Mark
authors.initials: M
authors.lastname: Brzezienski
authors.affiliation: Paces Plastic Surgery, Atlanta, Georgia;
authors.forename: Farzad R
authors.initials: FR
authors.lastname: Nahai
authors.affiliation: Pacira Pharmaceuticals, Inc, Parsippany, New Jersey;
authors.forename: Richard
authors.initials: R
authors.lastname: Scranton
authors.affiliation: The Wall Center for Plastic Surgery, Shreveport, Louisiana;
authors.forename: Holly
authors.initials: H
authors.lastname: Wall
authors.affiliation: The Wall Center for Plastic Surgery, Shreveport, Louisiana;
authors.forename: Simeon
authors.initials: S
authors.lastname: Wall
authors.affiliation: Charlotte Plastic Surgery, Charlotte, North Carolina, USA.
authors.forename: Stephan
authors.initials: S
authors.lastname: Finical
authors.affiliation: Charlotte Plastic Surgery, Charlotte, North Carolina, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Smith
keywords: Analgesia; Bupivacaine; Cosmetic surgery; Opioid analgesics; Postoperative pain
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