Deborah S Keller1, Rodrigo Pedraza2, Reena N Tahilramani3, Juan R Flores-Gonzalez4, Sergio Ibarra4, Eric M Haas5. 1. Colorectal Surgical Associates, Houston, TX, USA; Department of Surgery, Houston Methodist Hospital, Houston, TX, USA. 2. Department of Surgery, University of Texas Medical School at Houston, Houston, TX, USA. 3. Colorectal Surgical Associates, Houston, TX, USA; Department of Surgery, University of Texas Medical School at Houston, Houston, TX, USA. 4. Colorectal Surgical Associates, Houston, TX, USA. 5. Colorectal Surgical Associates, Houston, TX, USA; Department of Surgery, Houston Methodist Hospital, Houston, TX, USA; Department of Surgery, University of Texas Medical School at Houston, Houston, TX, USA. Electronic address: ehaasmd@houstoncolon.com.
Abstract
BACKGROUND: Our objective was to assess clinical and financial outcomes with long-acting liposomal bupicavaine (LB) in laparoscopic colorectal surgery. METHODS: Patients that received local infiltration with LB were strictly matched to a control group, and compared for postoperative pain, opioid use, length of stay (LOS), hospital costs, and complication, readmission, and reoperation rates. RESULTS: A total of 70 patients were evaluated in each cohort. Operative times and conversion rates were similar. LB patients had lower post-anesthesia care unit pain scores (P = .001) and used less opioids through postoperative day 3 (day 0 P < .01; day 1 P = .03; day 2 P = .02; day 3 P < .01). Daily pain scores were comparable. LB had shorter LOS (mean 2.96 vs 3.93 days; P = .003) and trended toward lower readmission, complication, and reoperation rates. Total costs/patient were $746 less with LB, a savings of $52,200 across the cohort. CONCLUSIONS: Using local wound infiltration with LB, opioid use, LOS, and costs were improved after laparoscopic colorectal surgery. The additional medication cost was overshadowed by the overall cost benefits. Incorporating LB into a multimodal pain regiment had a benefit on patient outcomes and health care utilization.
BACKGROUND: Our objective was to assess clinical and financial outcomes with long-acting liposomal bupicavaine (LB) in laparoscopic colorectal surgery. METHODS:Patients that received local infiltration with LB were strictly matched to a control group, and compared for postoperative pain, opioid use, length of stay (LOS), hospital costs, and complication, readmission, and reoperation rates. RESULTS: A total of 70 patients were evaluated in each cohort. Operative times and conversion rates were similar. LBpatients had lower post-anesthesia care unit pain scores (P = .001) and used less opioids through postoperative day 3 (day 0 P < .01; day 1 P = .03; day 2 P = .02; day 3 P < .01). Daily pain scores were comparable. LB had shorter LOS (mean 2.96 vs 3.93 days; P = .003) and trended toward lower readmission, complication, and reoperation rates. Total costs/patient were $746 less with LB, a savings of $52,200 across the cohort. CONCLUSIONS: Using local wound infiltration with LB, opioid use, LOS, and costs were improved after laparoscopic colorectal surgery. The additional medication cost was overshadowed by the overall cost benefits. Incorporating LB into a multimodal pain regiment had a benefit on patient outcomes and health care utilization.
Authors: Christopher Uhlig; Thomas Rössel; Axel Denz; Sven Seifert; Thea Koch; Axel Rüdiger Heller Journal: BMC Anesthesiol Date: 2019-08-17 Impact factor: 2.217
Authors: Alexander L Colonna; Brandon K Bellows; Toby M Enniss; Jason B Young; Marta McCrum; Jade M Nunez; Raminder Nirula; Richard E Nelson Journal: Surg Open Sci Date: 2020-01-23