Liposomal bupivacaine during subcutaneous implantable cardioverter defibrillator implantation for pain management

Justin Z. Lee, Amy E. Glasgow, Elizabeth B. Habermann, Luis Scott, Win-Kuang Shen, Fred M. Kusumoto, Christopher J. McLeod, Vasudha Goel, Pranita Kaginele, Yong Mei Cha, Paul A. Friedman, Samuel J. Asirvatham, Siva K. Mulpuru

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) has a larger generator and its implantation involves more dissection and tunneling compared to traditional transvenous defibrillator system. Liposomal bupivacaine, an extended-release bupivacaine with 72 h of duration has been used for postoperative pain management in patients undergoing S-ICD implantation. Our aim was to compare postoperative pain and opioid prescription patterns among patients undergoing S-ICD implantation who received intraprocedural liposomal bupivacaine and those who did not. Methods: We performed a retrospective analysis of all patients who underwent subcutaneous ICD implantation from January 1, 2013 to March 30, 2018 at the Mayo Clinic in Rochester, Minnesota. Patients were categorized into those who received liposomal bupivacaine and those who did not. Data on inpatient pain score, outpatient opioid prescription rates at discharge, and doses based on oral morphine equivalents (OME) were collected. Results: A total of 104 patients underwent S-ICD implantation. Intraprocedural liposomal bupivacaine was used in 69% of patients. Patients who received intraprocedural liposomal bupivacaine had similar mean inpatient pain scores (2.9 vs. 2.9, p =.786). There was also no difference in the rate of inpatient opioid administration (79.2% vs. 87.5%, p =.4139), outpatient opioid prescription (23.6% vs. 12.5%, p =.29), or mean OME (41.7-mg vs. 16.6-mg, p =.188) when comparing patients those who received intraprocedural liposomal bupivacaine and those who did not. Conclusion: Intraprocedural liposomal bupivacaine administration was not associated with any significant impact on postoperative pain scores, inpatient opioid administration, and outpatient opioid prescription rates or OME amounts at discharge.

Original languageEnglish (US)
Pages (from-to)513-518
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume44
Issue number3
DOIs
StatePublished - Mar 2021

Keywords

  • defibrillator
  • device
  • opioid prescription
  • quality improvement
  • subcutaneous implantable cardioverter defibrillator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Liposomal bupivacaine during subcutaneous implantable cardioverter defibrillator implantation for pain management'. Together they form a unique fingerprint.

Cite this