Local Infiltration of Liposomal Bupivacaine in Isolated Traumatic Rib Fractures

Authors

  • Kripa Shrestha TTUHSC - School of Medicine
  • Hsin Fang Li Providence Saint Joseph Health
  • Ariel Santos TTUHSC-School of Medicine, Department of Surgery
  • Justin Vaughan TTUHSC-School of Medicine, Department of Surgery
  • Fangyuan Zhang Providence Saint Joseph Health
  • Anna Sabu Kurian Texas Tech University Health Sciences Center
  • Brandon Couch TTUHSC
  • Charles Bayouth Providence Saint Joseph Health

Keywords:

bupivacaine, nerve block, rib fracture, pain score

Abstract

Introduction: Adequate pain control is essential in the management of traumatic rib fractures. Local infiltration of liposomal bupivacaine (LB) to provide intercostal nerve block has been added to the multimodal pain control regimens. We explored the effectiveness of LB infiltration around the site of rib fracture on pain score and total opioid use.


Methods: Patients with isolated rib fractures receiving additional infiltration of LB at the fracture site were compared to patients receiving only conservative treatment. A linear mixed model was performed to evaluate the impact of LB on pain score and total opioid use [morphine milligram equivalent per day (MME)].


Results:  Patients in the LB group experienced slightly, but insignificantly, greater pain scores. The adjusted mean MME was significantly higher compared to control (44.6 vs 24.4, p= 0.01), and increased over time (∆=5.7 and 6.6, p= 0.03 respectively at ~48h and ~96h, respectively).


Conclusion: No significant reductions in pain score and opioid requirement were achieved by additional local infiltration of LB in patients with isolated traumatic rib fractures.

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Published

06/06/2024

How to Cite

1.
Shrestha K, Li HF, Santos A, et al. Local Infiltration of Liposomal Bupivacaine in Isolated Traumatic Rib Fractures. WTJOM. 2024;2(1). Accessed July 15, 2024. https://westtexasjom.org/index.php/wtjm/article/view/16

Issue

Section

Surgery Section