Extended Release Liposomal Bupivacaine Injection (Exparel) for Early Postoperative Pain Control Following Palatoplasty

The Journal of Craniofacial Surgery
Kristopher M DayLarry A Sargent

Abstract

Liposomal bupivacaine (LB) is a long-acting local anesthetic reported to decrease postoperative pain in adults. The authors demonstrate the safe use of LB in pediatric patients with improved pain control following palatoplasty. Retrospective patient series of all single-surgeon palatoplasty patients treated at a tertiary craniofacial center from August 2014 to December 2015 were included. All patients received 1.3% LB intraoperatively as greater palatal nerve and surgical field blocks in 2-flap V-Y pushback palatoplasty. Postoperative oral intake, opioids administered, duration of hospitalization, and FLACC (face, legs, activity, cry, consolability) pain scores were measured. Twenty-seven patients (16 males and 11 females, average age of 10.8 months, weight 8.8 kg) received 2.9 ± 0.9 mL (2.6 ± 1.9 mg/kg) 1.3% LB. Average FLACC scores were 2.4 ± 2.2/10 in the postanesthesia care unit and 3.8 ± 1.8/10 while inpatients. Oral intake was first tolerated 10.3 ± 11.5 hours postoperatively and tolerated 496.4 ± 354.2 mL orally in the first 24 hours postoperatively. Patients received 8.5 ± 8.4 mg hydrocodone equivalents (0.46 ± 0.45 mg/kg per d hydrocodone equivalents) and were discharged 2.1 ± 1.3 days postoperatively. Opioid-related a...Continue Reading

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Citations

Jan 24, 2020·Annals of Plastic Surgery·Jiwon Sarah CrowleySamuel Lance
Oct 23, 2018·Current Opinion in Anaesthesiology·Andrew Iskander, Tong J Gan
Mar 21, 2020·The Journal of Craniofacial Surgery·Jiwon Sarah CrowleyAmanda Gosman
Jul 30, 2019·Otolaryngologic Clinics of North America·Brandon HopkinsAmelia F Drake
Feb 11, 2021·Plastic and Reconstructive Surgery. Global Open·Percy Rossell-PerryRenato Marca-Ticona
Feb 23, 2021·Facial Plastic Surgery & Aesthetic Medicine·Ghazal StaityJessyka G Lighthall
Mar 12, 2021·The Journal of Craniofacial Surgery·Haley Marie OberhoferJessica Ching
May 5, 2021·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Jason R SteinAlbert K Oh
May 13, 2021·Pediatric Quality & Safety·Melissa A LoPrestiSandi K Lam

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