PDF(Pubmed)
Abstract：
UNASSIGNED: The FDA recently approved Zynrelef® (A viscous solution of extended release of bupivacaine and meloxicam) to be applied at closure and providing postoperative analgesia for 72 hrs. Although the FDA didn\'t restrict the use of nerve blocks in combination with this formulation, the safety and efficacy of such a combination has yet to be documented. This quality improvement study investigated this combination within the FDA-approved indications.
UNASSIGNED: Selected surgeons at two hospitals were chosen to use Zynrelef®. According to the standard of care, surgeons were also allowed to request single nerve blocks before surgery. The type of nerve blocks (unilateral or bilateral) performed included quadratus lumborum and paravertebral blocks for abdominal surgery, and adductor canal block for total knee replacement. Each block was performed with 20 mL of 0.375% bupivacaine (n=129) or 0.5% of ropivacaine (n=30). Pain scores, opioid consumption, and prescription refill requests at discharge were recorded. Patients discharged on the same day of surgery were separated into two groups-those who received single nerve blocks plus an Zynrelef® (group 1) vs. those receiving Zynrelef® only (group 2) and was analyzed using an un-paired t-test.
UNASSIGNED: A total of 184 patients received Zynrelef®, including 25 patients who didn\'t receive blocks, 44 who received unilateral blocks and 114 who received bilateral blocks. No symptoms suggestive of Local Anesthetic Toxicity (LAST) were observed. The use of the combination was associated with a 50% reduction in the number of patients filling their opioid prescription.
UNASSIGNED: This study provides evidence that the combination of a single unilateral or bilateral nerve block with Zynrelef® is safe.
UNASSIGNED: Selected surgeons at two hospitals were chosen to use Zynrelef®. According to the standard of care, surgeons were also allowed to request single nerve blocks before surgery. The type of nerve blocks (unilateral or bilateral) performed included quadratus lumborum and paravertebral blocks for abdominal surgery, and adductor canal block for total knee replacement. Each block was performed with 20 mL of 0.375% bupivacaine (n=129) or 0.5% of ropivacaine (n=30). Pain scores, opioid consumption, and prescription refill requests at discharge were recorded. Patients discharged on the same day of surgery were separated into two groups-those who received single nerve blocks plus an Zynrelef® (group 1) vs. those receiving Zynrelef® only (group 2) and was analyzed using an un-paired t-test.
UNASSIGNED: A total of 184 patients received Zynrelef®, including 25 patients who didn\'t receive blocks, 44 who received unilateral blocks and 114 who received bilateral blocks. No symptoms suggestive of Local Anesthetic Toxicity (LAST) were observed. The use of the combination was associated with a 50% reduction in the number of patients filling their opioid prescription.
UNASSIGNED: This study provides evidence that the combination of a single unilateral or bilateral nerve block with Zynrelef® is safe.
摘要：
■FDA最近批准Zynrelef®(布比卡因和美洛昔康的缓释粘性溶液)在闭合时使用,并提供72小时的术后镇痛。尽管FDA并未限制神经阻滞与该制剂的联合使用，这种联合用药的安全性和有效性尚待记录.这项质量改进研究在FDA批准的适应症中调查了这种组合。
■选择两家医院的外科医生使用Zynrelef®。根据护理标准，外科医生也被允许在手术前请求单神经阻滞。进行的神经阻滞类型（单侧或双侧）包括腹部手术的腰方肌阻滞和椎旁阻滞，和内收肌管阻滞用于全膝关节置换术。每个模块使用20mL的0.375％布比卡因（n=129）或0.5％的罗哌卡因（n=30）进行。疼痛评分，阿片类药物的消费，并记录出院时的处方补充要求。手术当天出院的患者分为两组-接受单神经阻滞加Zynrelef®的患者（第1组）与仅接受Zynrelef®治疗的患者(第2组)进行非配对t检验分析.
■共有184名患者接受了Zynrelef®治疗，包括25名没有接受阻断的患者，44人接受单边区块，114人接受双边区块。没有观察到提示局部麻醉剂毒性(LAST)的症状。该组合的使用与满足阿片类药物处方的患者数量减少50％相关。
■这项研究提供了证据，证明单个单侧或双侧神经阻滞与Zynrelef®的组合是安全的。
■选择两家医院的外科医生使用Zynrelef®。根据护理标准，外科医生也被允许在手术前请求单神经阻滞。进行的神经阻滞类型（单侧或双侧）包括腹部手术的腰方肌阻滞和椎旁阻滞，和内收肌管阻滞用于全膝关节置换术。每个模块使用20mL的0.375％布比卡因（n=129）或0.5％的罗哌卡因（n=30）进行。疼痛评分，阿片类药物的消费，并记录出院时的处方补充要求。手术当天出院的患者分为两组-接受单神经阻滞加Zynrelef®的患者（第1组）与仅接受Zynrelef®治疗的患者(第2组)进行非配对t检验分析.
■共有184名患者接受了Zynrelef®治疗，包括25名没有接受阻断的患者，44人接受单边区块，114人接受双边区块。没有观察到提示局部麻醉剂毒性(LAST)的症状。该组合的使用与满足阿片类药物处方的患者数量减少50％相关。
■这项研究提供了证据，证明单个单侧或双侧神经阻滞与Zynrelef®的组合是安全的。
