The Use of Liposomal Bupivacaine in Interscalene Nerve Blocks

This paper outlines an educational research project at an urban hospital concerning the standardization of the use of liposomal bupivacaine (LB) for an interscalene block (ISB). The PICOT question guiding this project was: In adult surgical patients (P), how does the use of LB for shoulder peripheral nerve blocks, (I) compared to the administration of plain bupivacaine (PB) for shoulder peripheral nerve blocks, (C) affect postoperative pain scores (O) within 48 hours after surgery (T)? Using the numerical rating scale (NRS) for pain, a validated and reliable tool, patients who received LB had their 48-hour pain scores measured and compared to those patients who received PB. Satisfaction scores at 48 hours, a secondary project outcome, were assessed using a single question with a response scale of agree very much – disagree very much. Data was collected over a period of four weeks in those who were appropriate for the project. Data was collected by telephone and recorded on a data collection tool. Both PB and LB had the same mean immediate postoperative pain score (mean = 0.57), however, the mean 48-hour postoperative pain score was lower for those who received LB (mean = 3.29) compared to those who received PB (mean = 6.86). Patients who received LB were more satisfied with their anesthetic care (100% agree very much) compared to those who received PB (57.14% agree very much). From this data, it was concluded that LB provides a superior postoperative analgesic and surgical experience in comparison to PB.