Bupivacaine extended-release liposome injection is a novel formulation of bupivacaine designed to achieve long-acting postoperative analgesia.
The aim of this study was to compare the magnitude and duration of postoperative analgesia from a single dose of bupivacaine extended-release injection with placebo administered intraoperatively in patients undergoing hemorrhoidectomy.
This evaluation was a multicenter, randomized, double-blind, parallel-group, placebo-controlled phase 3 study.
Data were obtained from 13 centers in the Republic of Georgia, Poland, and Serbia.
Included in this study were patients aged 18 to 86 years undergoing excisional hemorrhoidectomy.
All patients received either a single dose of bupivacaine extended-release 300 mg or placebo administered intraoperatively via wound infiltration.
The cumulative pain score was assessed by measurement of the area under the curve of pain intensity through 72 hours after study drug administration.
One hundred eighty-nine patients were randomly assigned and treated; 186 completed the study. Pain intensity scores were significantly lower in the bupivacaine extended-release group in comparison with the group receiving placebo (141.8 vs 202.5, P < .0001). More patients in the bupivacaine extended-release group remained opioid free from 12 hours (59%) to 72 hours (28%) after surgery compared with patients receiving placebo (14% and 10%; P < .0008 through 72 h). The mean total amount of opioids consumed through 72 hours was 22.3 mg and 29.1 mg in the bupivacaine extended-release and placebo groups (P ≤ .0006). The median time to first opioid use was 14.3 hours in the bupivacaine extended-release group vs 1.2 hours in the placebo group (P < .0001). A greater proportion of patients in the bupivacaine extended-release group were satisfied with their postsurgical analgesia (95% vs 73%, P = .0007) than in the placebo group.
Bupivacaine extended-release demonstrated a statistically significant reduction in pain through 72 hours, decreased opioid requirements, delayed time to first opioid use, and improved patient satisfaction compared with placebo after hemorrhoidectomy.
1 The Mount Sinai Medical Center, New York, New York
2 Pacira Pharmaceuticals, Inc, Parsippany, New Jersey
3 Clinic for Digestive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Funding/Support: Pacira Pharmaceuticals, Inc.
Financial Disclosures: None reported.
Poster presentation at the meeting of the Society of Coloproctology of Yugoslavia, Belgrade, Serbia, October 7 to 9, 2010, and the meeting of The American Society of Colon and Rectal Surgeons, Vancouver, British Columbia, Canada, May 14 to 18, 2011.
Correspondence: Stephen R. Gorfine, M.D., The Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029-6574. E-mail: firstname.lastname@example.org