A prospective, randomized trial comparing liposomal bupivacaine versus fascia iliaca compartment block for postoperative pain control in total hip arthroplasty

• Published in: The Journal of arthroplasty
• Main Authors: McGraw-Tatum, Molly, DO, MSEd, Groover, Michael T., DO, George, Nicole E., BS, Urse, John S., DO, Heh, Victor, PhD
• Format: Journal Article
• Language: English
• Published: 2017
• Subjects: Orthopedics; total hip arthroplasty; LOS; FICB; length of stay; liposomal bupivacaine; multimodal pain control; THA; fascia iliaca compartment block
• ISSN: 0883-5403
• DOI: 10.1016/j.arth.2017.02.019

Background Increasing demand for total hip arthroplasty (THA) in a climate of increasing focus on clinical outcomes, patient satisfaction, and cost has created a need for better acute postoperative pain control for patients. An ideal pain control method would have few side effects, decrease opioid consumption, improved pain control, early ambulation, and decreased length of hospitalization. Methods We performed a prospective randomized controlled study involving 79 patients undergoing elective THA between June 2015 and February 2016. Forty patients received liposomal bupivacaine and 39 patients received a fascia iliaca compartment block (FICB). In addition, the medical records of 28 patients who underwent elective THA between May 2015 and December 2015 were retrospectively examined. Primary outcome: visual analog scale (VAS) pain scores and secondary outcomes: length of stay (LOS) and total opioid consumption. SPSS version 22 was utilized to run one-way ANOVA with contrast and Mood’s median test on the data. Results There were statistically significant decreases in pain intensity (p=0.019) and LOS (p=0.041) in both the liposomal bupivacaine group and the FICB groups compared to the retrospective control group. In addition, only the FICB group showed statistically significant decreased total opioid consumption compared to the retrospective group (p=0.028). Conclusion Patients undergoing elective THA have decreased overall pain intensity and shorter LOS with multimodal pain management regimen that includes either liposomal bupivacaine or FICB. Patients who received FICB required less overall total opioids than the control group.