Liposomal bupivacaine use in exploratory lingual nerve microsurgery: does liposomal bupivacaine use decrease postoperative pain and opioid consumption compared to bupivacaine hydrochloride? A pilot study

Objectives: The purpose of this study was to determine if liposomal bupivacaine 1.3% (LB), Exparel (Pacira Pharmaceuticals), is more effective than bupivacaine hydrochloride 0.25% (BH), Marcaine (Hospira), in reducing postoperative pain and opioid consumption in patients undergoing exploratory lingual nerve microsurgery. The investigators hypothesized that patients who received LB would have a greater reduction in acute postoperative pain, and therefore, a reduction in total opioid use over 72 hours postoperatively. Method and materials: This was a retrospective study. All patients had undergone outpatient lingual nerve microsurgery at University Hospital in Newark, NJ, by principal investigator (VBZ). The research design consisted of two groups. One group received BH, while the other received LB. Participants were administered a telephone questionnaire after obtaining verbal consent. Subjective pain intensity from 0 to 72 hours postoperatively was evaluated on a numeric rating scale (NRS). Additionally, total opioid consumption was evaluated. Results: Sample size was composed of 20 patients: 11 patients in the BH group, and 9 patients in the LB group. Less perceived pain was reported by subjects in the LB group, and more significantly, less opioid pill consumption. Conclusion: The purpose of this study was to conduct a retrospective analysis addressing the following question: “Does LB use decrease postoperative pain and opioid consumption in exploratory lingual nerve microsurgery?” Results showed that intraoperative use of LB was associated with decreased postoperative pain, and decreased opioid pill consumption, when compared to BH, through its prolonged duration of action. The results from this pilot study support LB use in lingual nerve microsurgery.