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Peripheral nerve blockade with combined standard and liposomal bupivacaine in major lower‐extremity amputation

Pain Practice Mar 19, 2021

Dumitrascu CI, Warner NS, Stewart TM, et al. - Researchers examined the utility of liposomal bupivacaine as a component of peripheral nerve blockade for lower‐extremity amputation. In this observational study, three different perioperative analgesic techniques were compared for adults undergoing major lower‐extremity amputation under general anesthesia: (1) no regional anesthesia, (2) peripheral nerve blockade with standard bupivacaine, and (3) peripheral nerve blockade with a mixture of standard and liposomal bupivacaine. Included were 631 unique anesthetics for 578 unique patients; these comprised 416 (66%) without regional anesthesia, 131 (21%) with peripheral nerve blockade with a mixture of standard and liposomal bupivacaine, and 84 (13%) with peripheral nerve blockade with standard bupivacaine alone. Reduced opioid requirements were observed after lower‐extremity amputation in correlation with peripheral nerve blockade vs general anesthesia alone. However, the incorporation of liposomal bupivacaine does not differ significantly from blockade utilizing only standard bupivacaine.

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