Table 3 Summary of researches with negative efficacy of EXPAREL
From: Advances of Nano-Structured Extended-Release Local Anesthetics
Reference Number | Route | Comparison | Surgery | Primary Outcome | Results |
|---|---|---|---|---|---|
[68] | Periarticular injection | Standardized cocktail | Total knee arthroplasty | VAS, total-morphine-equivalents (TME), and opioid-related-symptoms-distress-Scale (OR-SDS) at 24 and 48 h postoperatively | The LB group (n = 52, TME = 51.5) required significantly more narcotics than control (n = 52, TME = 30.03), p = 0.025 |
[69] | Periarticular injection | Perioperative nerve block, ropivacaine periarticular injection | Total knee arthroplasty | Maximal NRS in intention- to-treat analysis | Median maximal pain scores were significantly lower for peripheral nerve blockade (n = 50) compared to LB group (n = 52) (p = 0.016) |
[70] | Periarticular injection | Femoral nerve block | Anterior cruciate ligament reconstruction | Postoperative VAS for 4 days | A significant increase in pain in LB group (n = 41) between 5 and 8 h compared to control (n = 41) postoperatively (6.3 ± 2.0 versus 4.8 ± 2.6; p = 0.01) |
[71] | Posterior vaginal wall infiltration | Saline | Posterior vaginal wall surgery | Morphine equivalent narcotic usage, pain score on postoperative day 1, 3, 7 | No difference observed (study group n = 49, control group n = 51) |
[72] | Parasternal nerve block | Saline | Median sternotomy for coronary revascularization | Total amount of narcotic pain medication used, patient`s pain score within the first 72 h postoperatively | No difference between two groups (study group n = 38, control group n = 41) |
[73] | Intraoperative local infiltration | Preoperative interscalene nerve block | Shoulder arthroplasty | Postoperative average daily VAS scores for 4 days | Significant increase in pain in the LB group (n = 26) between 0 and 8 h postoperatively (5.3 vs. 2.5, p = .001) compared to control (n = 31) |
[74] | Infiltration | Interscalene Block | Shoulder arthroplasty | Morphine equivalent units (MEU) consumed over the first 24 h | Similar MEU over the first 24 h; intraoperative narcotics and mean VAS pain score were significantly lower in control than in LB group (8.9 ± 4.1 vs. 16.2 ± 7.0 MEU p < 0.001; at 0 h 0.8 ± 2.2 vs. 3.3 ± 2.7 points, p < 0.001; at 8 h 1.4 ± 2.4 vs. 3.2 ± 2.2 points; p < 0.001). (n = 78 in all groups) |