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Efficacy of new long-acting bupivacaine HTX-011 in providing pain relief for patients undergoing elective surgery – A meta-analysis of prospective randomized controlled trials
Basavana Goudra1, Navdeep Singh2, Linag Xue3, Amandeep Goyal4, Divakara Gouda1, Preet Mohinder Singh5
1 Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
2 Department of Surgery, Division of Abdominal Transplant Surgery, The Ohio State University, Columbus, Ohio, USA
3 Valley Consortium for Medical Education Family Medicine Program, Modesto, CA, USA
4 Department of Medicine, Marietta Memorial Hospital, Marietta, Ohio, USA
5 Department of Anesthesiology, Washington University, Saint Louis, MO, USA
Correspondence Address:
Prof. Basavana Goudra
Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, 680 Dulles, 3400 Spruce Street, Philadelphia, PA 19104
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/aer.AER_34_20
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Background: The aim of the present meta-analysis is to critically analyze the various prospective randomized controlled trials comparing the safety and efficacy of a new, yet unapproved long-acting local anesthetic HTX-011. This is a combination of bupivacaine and meloxicam, and like its predecessors' liposomal bupivacaine and SABER bupivacaine, the combination slowly releases bupivacaine and provides therapeutic analgesic concentrations at the site of infiltration. Methods: We performed a meta-analysis of 7 randomized clinical trials comparing the use of HTX-011 with placebo and/or bupivacaine in patients undergoing abdominoplasty, bunionectomy, and herniorrhaphy. Comparisons were made for the patients who were opioid free at 24 h, pain scores at 24 h, patients likely to be opioid free at 72 h, and reduction of morphine consumption at 72 h. Results: While comparing pain scores at 24 h, we found that the use of HTX-011 was associated with a significant decrease in pain score in relation to both bupivacaine and placebo. The overall comparison of 12 groups showed that with HTX-011, patients are 3.25 times more likely to be opioid free at 72 h than either placebo or control. More patients were free of opioid at 24 h in the HTX-011 group when compared to bupivacaine. Finally, the consumption of morphine was less by 10.61 (95% CI: 8.13–13.09) in 14 groups that reported such consumption. Conclusion: HTX-011 has a clear advantage in comparison to both placebo and bupivacaine and provides better pain relief and reduces opioid consumption. |
