IADR Abstract Archives
Opioid Prescribing Patterns and Complications Associated With Liposomal Bupivacaine Use
Objectives: Liposomal bupivacaine (Exparel®) is an aqueous suspension of multivesicular liposomes containing bupivacaine particles (13.3 mg/mL). After injection into soft tissue, liposomal bupivacaine is slowly released over a period of time to provide postoperative analgesia for several days after surgery. The purpose of this study is to evaluate opioid prescribing patterns and postoperative complications in patients undergoing third molar removal treated with and without liposomal bupivacaine.
Methods: Retrospective review of patients who underwent extraction of impacted mandibular third molars from 2020-2022 by a single surgeon. Data collected included demographics, procedure performed, use of liposomal bupivacaine, number of opioids prescribed for postoperative analgesia, postoperative complications, and number of opioids prescribed for rescue analgesia in the setting of a complication.
Results: 230 patients were identified with a mean age of 23.6 years (100 males, 130 females). 62 (26.9%) of patients received liposomal bupivacaine. 60 (26%) patients were not prescribed any opioids at the time of their third molar removal (all received liposomal bupivacaine). For patients who were prescribed opioids (170), the average number of opioids prescribed was 8.7 tablets. 10 (4.3%) patients developed surgical site infections requiring antibiotics and 7 of these patients received liposomal bupivacaine. 22 (9.5%) patients developed alveolar osteitis and 4 of these patients received liposomal bupivacaine. Other complications included temporary inferior alveolar nerve paresthesia in 3 (1.3%) patients. 18 (7.8%) patients received a rescue prescription for opioids (average 12.8 tablets).
Conclusions: The administration of liposomal bupivacaine during third molar removal can eliminate the need to prescribe opoids for postoperative analgesia. Surgical site infections were more common in patients who received liposomal bupivacaine. Alveolar osteitis was seen more frequently in patients who did not receive liposomal bupivacaine.
Methods: Retrospective review of patients who underwent extraction of impacted mandibular third molars from 2020-2022 by a single surgeon. Data collected included demographics, procedure performed, use of liposomal bupivacaine, number of opioids prescribed for postoperative analgesia, postoperative complications, and number of opioids prescribed for rescue analgesia in the setting of a complication.
Results: 230 patients were identified with a mean age of 23.6 years (100 males, 130 females). 62 (26.9%) of patients received liposomal bupivacaine. 60 (26%) patients were not prescribed any opioids at the time of their third molar removal (all received liposomal bupivacaine). For patients who were prescribed opioids (170), the average number of opioids prescribed was 8.7 tablets. 10 (4.3%) patients developed surgical site infections requiring antibiotics and 7 of these patients received liposomal bupivacaine. 22 (9.5%) patients developed alveolar osteitis and 4 of these patients received liposomal bupivacaine. Other complications included temporary inferior alveolar nerve paresthesia in 3 (1.3%) patients. 18 (7.8%) patients received a rescue prescription for opioids (average 12.8 tablets).
Conclusions: The administration of liposomal bupivacaine during third molar removal can eliminate the need to prescribe opoids for postoperative analgesia. Surgical site infections were more common in patients who received liposomal bupivacaine. Alveolar osteitis was seen more frequently in patients who did not receive liposomal bupivacaine.