Interscalene nerve block with plain bupivacaine versus liposomal bupivacaine for arthroscopic rotator cuff repair: A randomized controlled trial.

Background: Although single injections with anesthetics are commonly administered given their safety, their short-acting nature limits pain control. Liposomal bupivacaine represents a promising alternative to plain bupivacaine in interscalene nerve blocks. The goal of our study was to determine whether an interscalene block with liposomal bupivacaine provides superior analgesia and reduces opioid requirements compared to plain bupivacaine in patients undergoing arthroscopic rotator cuff repair (ARCR). Methods and Materials: A single-center, double-blinded, randomized controlled trial of patients undergoing ARCR was performed. Patients received a single-shot interscalene nerve block with plain bupivacaine or liposomal bupivacaine. Visual analog scale pain scores at rest and with activity, as well as morphine milligram equivalents, were recorded in postoperative recovery and on postoperative days 1, 2, 3, and 7. Comparisons between groups were made using descriptive statistics; the significance level was set at Results: A total of 41 patients were randomized into the liposomal bupivacaine ( Conclusion: There was no difference in the visual analog scale or morphine milligram equivalents after arthroscopic rotator cuff repair with interscalene blocks using liposomal bupivacaine versus plain bupivacaine. Given the increased cost associated with liposomal bupivacaine use and the variation in multimodal pain regimens worldwide, multicenter clinical trials are necessary to examine the clinical benefit and cost-effectiveness of liposomal bupivacaine in patients undergoing rotator cuff repair.