ICJR Interviews: Liposomal Bupivacaine Is Effective for Pain after TSA

    The gold standard for pain control following total shoulder arthroplasty is an interscalene nerve block.

    It’s an effective technique for pain control, but interscalene nerve block requires an anesthesiologist to place the catheter preoperatively, and it has been associated with the risk of nerve injury.

    An effective alternative may be liposomal bupivacaine administered intra-articularly during the procedure by the surgeon, according to a recent retrospective cohort analysis from Johns Hopkins University in Baltimore, Maryland.

    At 18 to 24 hours after surgery, liposomal bupivacaine provided statistically and substantially significant improvement in pain, said Umasuthan Srikumaran, MD, one of the study authors. At all other time points, pain levels were similar.

    Dr. Srikumaran concluded that liposomal bupivacaine seems to as effective as interscalene nerve block. It has the benefit of eliminating the risk of nerve associated with interscalene nerve block, and it can be given to patients for whom an interscalene nerve block is contraindicated.

    And, significantly, intraoperative administration by the surgeon has the potential to improve perioperative efficiency compared with preoperative catheter placement by the anesthesiologist, Dr. Srikumaran noted.

    Click the image above to hear Dr. Srikumaran discuss the study, “Liposomal Bupivacaine vs. Interscalene Nerve Block for Pain Control after Shoulder Arthroplasty: A Retrospective Cohort Analysis,” which was presented during the American Shoulder and Elbow Surgeons’ Specialty Day during the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando.

    Producer and Director: Michael Bugera; Post Production: Charles J. Maynard