Faculty Sponsor: Dr. Nalia Mamoon
Postoperative pain management can be difficult for many patients after arthroscopic rotator cuff surgery. Typically, interscalene bupivacaine blocks are used to provide analgesia for 8-18 hours after injection; however, when the block wears off, patients can experience intense rebound pain (sudden pain after sensation returns to the area). A new analgesic (Exparel) was approved by the FDA for use in 2018, which formulates bupivacaine into an aqueous suspension of multivesicular liposomes.2 Bupivacaine is then released from the liposomes over a longer period of time, providing a longer lasting analgesia. Liposomal bupivacaine (Exparel) and its effects as an interscalene brachial plexus block are not well studied in arthroscopic rotator cuff repairs. This study investigates the effects of a single injection interscalene block of liposomal bupivacaine (Exparel) on patient reported outcomes such as pain, opioid use, and sleep quality. 25 patients will be recruited in this prospective study on anesthetic care at Gateway Surgery Center (GSC) using a postoperative questionnaire. After obtaining the patient’s consent, a form will be given to the patient after completion of the surgery, which will then be filled out over the course of the next 14 days. Email reminders were sent on post-operative days 1, 2, and 3 and before returning for the first post-operative clinic visit where the questionnaire was collected. The data was collected and analyzed using chi-square or Fishers Exact tests for categorical variables (rebound pain), Wilcoxon-Mann Whitney test for ordinal variables (pain and sleep) and student t-tests for continuous variables (Opioid use). Currently, we do not have enough data to present our findings, but if pain levels, opioid use, and rebound pain are found to low, then implementing Exparel more widely in surgery centers for arthroscopic rotator cuff repair. It would also be imperative to investigate the analgesic effects of Exparel in other surgical scenarios.