Impact of long-acting local anesthesia on clinical and financial outcomes in laparoscopic colorectal surgery

- We performed a case-matched study to assess postoperative pain, opioid use, length of stay, hospital costs, complication, readmission, and reoperation rates with long-acting liposomal bupicavaine (LB) in laparoscopic colorectal surgery. With LB, opioid use, length of stay, and costs were improved. The additional medication cost was overshadowed by the overall cost benefits. Incorporating LB into a multimodal pain regiment could benefit patient outcomes and health care utilization.

BackgroundOur objective was to assess clinical and financial outcomes with long-acting liposomal bupicavaine (LB) in laparoscopic colorectal surgery.MethodsPatients that received local infiltration with LB were strictly matched to a control group, and compared for postoperative pain, opioid use, length of stay (LOS), hospital costs, and complication, readmission, and reoperation rates.ResultsA total of 70 patients were evaluated in each cohort. Operative times and conversion rates were similar. LB patients had lower post-anesthesia care unit pain scores (P = .001) and used less opioids through postoperative day 3 (day 0 P < .01; day 1 P = .03; day 2 P = .02; day 3 P < .01). Daily pain scores were comparable. LB had shorter LOS (mean 2.96 vs 3.93 days; P = .003) and trended toward lower readmission, complication, and reoperation rates. Total costs/patient were $746 less with LB, a savings of $52,200 across the cohort.ConclusionsUsing local wound infiltration with LB, opioid use, LOS, and costs were improved after laparoscopic colorectal surgery. The additional medication cost was overshadowed by the overall cost benefits. Incorporating LB into a multimodal pain regiment had a benefit on patient outcomes and health care utilization.