TY - JOUR AU - Dominguez, Dana A. AU - Ely, Sora AU - Bach, Cynthia AU - Lee, Tina AU - Velotta, Jeffrey B. PY - 2018 TI - Impact of intercostal nerve blocks using liposomal versus standard bupivacaine on length of stay in minimally invasive thoracic surgery patients JF - Journal of Thoracic Disease; Vol 10, No 12 (December 30, 2018): Journal of Thoracic Disease Y2 - 2018 KW - N2 - Background: Postsurgical pain control can have a significant impact on patient outcomes and hospital-associated costs. We sought to evaluate the effect of intercostal nerve blocks using liposomal bupivacaine on length of stay (LOS) in patients undergoing video-assisted thoracoscopic surgery (VATS). Methods: We retrospectively reviewed outcomes in 80 patients undergoing VATS wedge resection, VATS lobectomy, or minimally-invasive esophagectomy (MIE). Patients received either liposomal bupivacaine (n=40) or standard-release bupivacaine with epinephrine (n=40) via intercostal nerve block. The LOS, 24-hour postoperative pain scores, overall opioid usage, and patient ambulation rates at 24 hours were compared for the two groups. Results: The median LOS was significantly shorter in patients receiving liposomal bupivacaine, at 1.35 days (IQR, 1.28 to 1.53 days) compared to 2.45 days (IQR, 2.08 to 3.51 days) in patients receiving standard-release bupivacaine (P vs . 31.9±20.9 mg, respectively, P=0.664). Interestingly, however, 93% (37/40) of patients receiving liposomal bupivacaine were able to ambulate within 24-hours after surgery, compared to 65% (26/40) of patients in the control group (P=0.003). Conclusions: The use of liposomal bupivacaine is associated with decreased LOS in postoperative thoracic surgery patients and earlier return to ambulation. It does not, however, decrease 24-hour postoperative pain scores or opioid usage. UR - https://jtd.amegroups.org/article/view/25170