Comparison of Local Infiltration Analgesia to Bupivacaine Wound Infiltration as Part of a Multimodal Pain Program in Total Hip Replacement


Insufficient control of pain after total hip arthroplasty (THA) can delay rehabilitation and adversely affect
long-term surgical outcomes. The current study directly compares 36 THA patients who were given a
routine wound infiltration (RWI group) with 36 patients who were administered an injection of liposomal
bupivacaine infiltration (LBUP group). Average visual analog scale pain scores were significantly higher for RWI patients (2.20 vs. 1.34, p D .0013) overall and trended higher for each day after surgery up to day 5. The average number of opioid doses was 13.14 for the RWI group compared with 4.97 for the LBUP group (p < .0001), and the total opioid dosage consumed was greater in the RWI group (105.4 vs. 72.3, p D .0075; significant only in regression model). The results of this study support the conclusion that liposomal bupivacaine infiltration, as part of a multimodal program after THA, can improve postoperative analgesia and reduce opioid consumption when compared with routine wound infiltration. (Journal of Surgical Orthopaedic Advances 24(4):235–241, 2015) Key words: analgesia, liposomal bupivacaine, total hip arthroplasty, wound infiltration

Roger H. Emerson, Jr., MD; John W. Barrington, MD; Oluseun Olugbode, MS; Scott Lovald, PhD, MBA; Heather Watson, PhD; Kevin Ong, PhD