August 2017

Pacira’s Exparel cuts post-TKA opioid use

The Journal of Arthroplasty in August published data showing local infiltration analgesia (LIA) with liposomal bupivacaine (LB) made by Parsippany, NJ-based Pacira Pharmaceuticals improves pain scores and reduces opioid use after total knee arthroplasty (TKA) compared with LIA alone.

The trial randomized 140 patients undergoing primary unilateral TKA to LIA with a single dose of Exparel, LB 266 mg/20 mL admixed with bupivacaine HCl .5% 20 mL, or LIA with bupivacaine HCl .5% 20 mL alone, each expanded with saline to a total volume of 120 mL.

Investigators compared the effects of LIA with or without LB on visual analog pain scores (VAS) and opioid consumption.

VAS pain was significantly lower in the LB group 12 to 48 hours postprocedure, as was total opioid use 0 to 48 hours after TKA. Significant differences in favor of LB were observed for the percentage of opioid-free patients and time to first opioid rescue. Both treatments were well-tolerated.

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