Table 2 Summary of researches with positive efficacy of EXPAREL
From: Advances of Nano-Structured Extended-Release Local Anesthetics
Reference number | Route | Comparison | Surgery | Primary outcome | Results |
|---|---|---|---|---|---|
[59] | Injection into the trocar path and vaginal incision | Saline | Retropubic midurethral sling | VAS pain score 4 hours after discharge home | Pain score was lower in intervention group (n = 54, 3.5), than in control group (n = 55, 3.5) (p = 0.014) |
[60] | Interscalene block | Continuous interscalene nerve block with plain bupivacaine | Shoulder arthroplasty | Pain assessment up to 24h after surgery, all doses and times of narcotics during the inpatient stay | No significant difference for primary end point; LB group (n = 34) had higher American Shoulder and Elbow Surgeons score (74.5) and Penn Shoulder Score (72.3) than control (n = 32, 59.7, 56.3) at final follow-up |
[61] | Posterior intercostal nerve block | Thoracic EPI | Lung resection | Perioperative morbidity, pain scores and narcotic requirements | Non-inferior analgesia of LB group compared to control (n = 54 respectively) |
[62] | Multilevel intercostal nerve block | EPI | Open thoracotomy | Mean pain score on POD 1, 2, 3, supplemental narcotic utilization, total length of hospital stays | LB group (n = 53) showed lower mean pain score on day 1 (p < 0.04) and 3 (p < 0.04) compared to EPI (n = 32), the length of hospital stay was longer in LB group (7.4 days) compared to EPI group (9.3 days) (p < 0.05) |
[63] | Intraoperative intrathoracic intercostal nerve rib blocks | Thoracic with bupivacaine hydrochloride | Video-assisted thoracoscopic pulmonary resection | Pain score, postoperative opioid medication | LB group had significantly lower VAS scores (n = 143, 3.9 versus 4.5, p < 0.05), decreased postoperative opioid medication (morphine equivalent dose during the first 3 days: 344.5 versus 269.5, p < 0.05) than control (n = 237) |
[64] | Post-incisional TAP | Plain bupivacaine infiltration | Bariatric Surgery | All narcotics used | LB group (n = 233, 44.5mg) required less narcotic than control group for entire hospital stay (n = 243, 78.0mg) (p = 0.00001) |
[65] | TAP | Pain catheter (OnQ) | Delayed unilateral deep inferior epigastric perforator reconstruction | Intravenous, oral and total narcotics utilization | LB group (n = 6) compared to OnQ group (n = 6) used 19.3 mg vs. 29.6 mg intravenously, 40.9mg vs. 53.2mg in total (p = 0.005, < 0.001= respectively |
[66] | TAP | Intravenous patient control analgesia (IV PCA), EPI | Major lower abdominal surgery | Total postoperative IV morphine-equivalent dose of opioid and time-weighted average NRS pain scores | TAP infiltration (n = 108) was noninferior to EPI (n = 108)on both primary outcomes (p < 0.001) |
[67] | TAP | 0.25% bupivacaine injection | Laparoscopic hand-assisted donor nephrectomy | Maximal pain scores, opioid consumption at 24, 48, 72 h postoperatively | LB group (n = 30) compared with control (n = 29) median, showed lower pain scores on 24–48 h after injection (5 vs. 6, p = 0.009); on 48–72 h after injection (3 vs. 5, p = 0.02); and fewer opioid use on 48–72 h after injection (105 vs. 182, p = 0.03) |