Presentation Details
| Postoperative Outcomes Following Exparelvs.ZynrelefLocal Infiltration Analgesia (LIA) in Joint Replacement Surgery Ha Neul Yang1, Gurpreet S Bajaj1, 2, Adam Whitmire1, Oscar Torres1, Raunak Bajaj1. 1Texas Health Huguley Hospital, Burleson, TX, USA.2Lone Star Orthopaedic and Spine Specialists, Burleson, TX, USA |
Abstract
BACKGROUND: Total joint arthroplasty is one of the most commonly performed surgeries in the United States, and approximately, 30% of patients require opioids to manage postoperative pain following the surgery [2]. The local infiltration analgesia with local anesthetic bupivacaine has been suggested as an optimal modality associated to reduce opioid consumption and improve pain scores. However, the amide local anesthetic like bupivacaine has been falling out of favor due to its shorter duration of action, instead, bupivacaines with different drug release system have been utilized in the orthopedic setting to provide longer analgesia.
METHODS: This retrospective review was conducted at a single-center, 300-bed community hospital from November 2023 to May 2024. Eligible patients were adults aged 18 years or older who underwent unilateral primary total hip or knee joint replacement by 3 surgeons and were enrolled in the hospital’s Joint Program from November 2023 until May 2024. All patients underwent the joint replacement procedures and received either liposomal bupivacaine 266mg or 400mg bupivacaine and 12mg meloxicam during surgery. Patient’s EMR record was reviewed retrospectively.
RESULTS: Post-operative opioid consumption was significantly lower with Zynrelef® compared with Exparel® (50 MME vs. 130 MME, respectively, p<0.001). The average daily ambulation was higher in Zynrelef® group with a statistical difference (p=0.027). Finally, patients treated with Zynrelef® had a shorter length of hospital stay compared to Exparel® group (1.38 days vs. 1.71 days p<0.001). Zynrelef® group had higher rates of complication and readmission without statistical difference. No cases of local anesthetic systemic toxicity (LAST) were reported from both groups.
CONCLUSIONS: Patients underwent total knee and hip arthroplasty and received Zynrelef® received less opioids and ambulated greater distance per day with a shorter hospitalization compared to Exparel®. These findings highlight the potential benefits of Zynrelef® but confirmation through future prospective, randomized, multicenter studies are warranted.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
METHODS: This retrospective review was conducted at a single-center, 300-bed community hospital from November 2023 to May 2024. Eligible patients were adults aged 18 years or older who underwent unilateral primary total hip or knee joint replacement by 3 surgeons and were enrolled in the hospital’s Joint Program from November 2023 until May 2024. All patients underwent the joint replacement procedures and received either liposomal bupivacaine 266mg or 400mg bupivacaine and 12mg meloxicam during surgery. Patient’s EMR record was reviewed retrospectively.
RESULTS: Post-operative opioid consumption was significantly lower with Zynrelef® compared with Exparel® (50 MME vs. 130 MME, respectively, p<0.001). The average daily ambulation was higher in Zynrelef® group with a statistical difference (p=0.027). Finally, patients treated with Zynrelef® had a shorter length of hospital stay compared to Exparel® group (1.38 days vs. 1.71 days p<0.001). Zynrelef® group had higher rates of complication and readmission without statistical difference. No cases of local anesthetic systemic toxicity (LAST) were reported from both groups.
CONCLUSIONS: Patients underwent total knee and hip arthroplasty and received Zynrelef® received less opioids and ambulated greater distance per day with a shorter hospitalization compared to Exparel®. These findings highlight the potential benefits of Zynrelef® but confirmation through future prospective, randomized, multicenter studies are warranted.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
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