Nicklaus Children's Hospital, Miami, FL.
Pacira BioSciences, Inc, Parsippany, NJ.
J Cardiothorac Vasc Anesth. 2021 Dec;35(12):3681-3687. doi: 10.1053/j.jvca.2021.04.003. Epub 2021 Apr 14.
Effective postsurgical pain management is important for pediatric patients to improve outcomes while reducing resource use and waste. The authors examined opioid consumption and economic outcomes associated with liposomal bupivacaine (LB) or non-LB analgesia use in pediatric patients undergoing cardiothoracic surgery.
The authors retrospectively analyzed Premier Healthcare Database records.
The data extracted from the database included patient records from hospitals across the United States in both rural and urban locations.
The records included data from patients aged 12-to-<18 years.
The records belonged to patients undergoing video-assisted thoracoscopic procedures (VATS) who received LB or non-LB analgesia after surgery.
Outcomes included in-hospital postsurgical opioid consumption in morphine milligram equivalents (MMEs), hospital length of stay (LOS), and total hospital costs; the LB and non-LB cohorts were compared using a generalized linear model with inverse probability of treatment weighting to balance the cohorts. For VATS procedures, pediatric patients receiving LB had significant reductions in in-hospital opioid consumption (632 v 991 MMEs; p < 0.0001), shorter LOS (5.1 v 5.6 days; p = 0.0023), and lower total hospital costs ($18,084 v $21,962; p < 0.0001) compared with those receiving non-LB analgesia.
These results support use of LB in multimodal analgesia regimens for managing pain in pediatric patients after cardiothoracic surgery.
有效的术后疼痛管理对儿科患者很重要，可改善治疗结果，同时减少资源的使用和浪费。作者研究了行心胸外科手术后使用脂质体布比卡因（LB）或非-LB 镇痛药物与阿片类药物消耗和经济结果之间的关系。
作者回顾性分析了 Premier Healthcare Database 记录。
从数据库中提取的数据包括来自美国农村和城市地区医院的患者记录。
记录包括年龄在 12 岁至<18 岁之间的患者数据。
记录包括接受 LB 或非-LB 镇痛药物治疗的接受电视辅助胸腔镜手术（VATS）的患者手术后的住院期间术后阿片类药物消耗（以吗啡毫克当量计，MME）、住院时间（LOS）和总住院费用。使用逆概率治疗加权的广义线性模型比较 LB 和非-LB 队列，以平衡队列。对于 VATS 手术，接受 LB 的儿科患者在住院期间阿片类药物消耗（632 与 991 MME；p < 0.0001）、住院时间（5.1 与 5.6 天；p=0.0023）和总住院费用（18084 美元与 21962 美元；p < 0.0001）方面均显著降低，而非接受非-LB 镇痛药物治疗的患者。
这些结果支持在心胸外科手术后儿科患者的多模式镇痛方案中使用 LB。
