Liposomal Bupivacaine in Hallux Valgus Surgery: A Multimodal Pain Management Adjunct

The objective of this study was to review the use of liposomal bupivacaine as a multimodal pain management adjunct following hallux valgus surgery. The study was a prospective review of a consecutive series of patients who underwent hallux valgus surgery and received liposomal bupivacaine.
From postoperative day (POD) 1 to 4, pain scores, number of narcotic rescue pills used, and adverse events were recorded. Wound complications, narcotic refills, and unscheduled clinic and emergency room (ER) visits or hospital admissions for pain were also recorded. The average pain rating was <3.4 (š2.4) during POD 1 to 4. Four patients (28.6%) reported never experiencing pain (Numeric Rating Scale 1). Seventy-one percent used narcotic rescue pills on POD 1. There were no unscheduled office or ER visits or hospital admissions. One adverse event and one wound complication occurred. Liposomal bupivacaine may be a safe and useful adjunct in a multimodal pain regimen for patients undergoing hallux valgus surgery. More rigorous studies are needed to determine its efficacy, safety profile, and cost-effectiveness compared to placebo. (Journal of Surgical Orthopaedic Advances 23(4):198–202, 2014) Key words: hallux valgus surgery,liposomal bupivacaine, multimodal pain management, postoperative pain