BACKGROUND Liposomal bupivacaine (LB) is a long-lasting local anesthetic agent that was developed for use in the surgical setting to help manage postoperative pain. The objective of this study was to evaluate the effect of LB on postoperative pain, function, and overall hospital course in patients with intracapsular hip fractures who were treated with hip hemiarthroplasty. METHODS This was a single-center, randomized prospective double-blinded study of 50 patients with an isolated intracapsular femoral neck fracture who were treated with hip hemiarthroplasty from 2018 to 2022. The study group consisted of 25 patients who were treated with intraoperative LB and bupivacaine hydrochloride injections, while the control group consisted of 25 patients who were treated with intraoperative bupivacaine hydrochloride injections only. Primary outcomes were a visual analog scale (VAS) score for pain, total morphine milligram equivalents (MME), delirium, and time to ambulation with physical therapy. RESULTS No significant differences between the study and control groups were found in any of the outcomes measured. Most notably, there were no differences in the average postoperative pain score (VAS, 2.26 versus 2.7; p = 0.34), total MME used postoperatively (11.73 versus 9.98 MME; p = 0.71), and postoperative day of discharge (4.00 versus 3.88 days; p = 0.82). CONCLUSIONS The results of our study suggest that use of LB is not associated with substantially improved postoperative pain or function or with a shorter hospital course following hip hemiarthroplasty for a femoral neck fracture. Given the higher cost of LB compared with standard postoperative pain modalities, it is worth questioning its use in the setting of geriatric hip fractures. LEVEL OF EVIDENCE Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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脂质体布比卡因不会减轻接受半关节置换术治疗的股骨颈囊内骨折患者的术后疼痛：HEAT-A 随机对照试验。


背景脂质体布比卡因 （LB） 是一种长效局部麻醉剂，专为手术环境开发，以帮助控制术后疼痛。本研究的目的是评估 LB 对接受髋关节置换术治疗的囊内髋部骨折患者术后疼痛、功能和整体住院过程的影响。方法 这是一项单中心、随机、前瞻性双盲研究，纳入了 2018 年至 2022 年接受髋关节置换术治疗的 50 例孤立性股骨颈囊内骨折患者。研究组由 25 名术中接受 LB 和盐酸布比卡因注射治疗的患者组成，而对照组由 25 名术中仅接受盐酸布比卡因注射治疗的患者组成。主要结局是疼痛视觉模拟量表 （VAS） 评分、吗啡总毫克当量 （MME） 、谵妄和物理治疗下行走时间。结果 研究组和对照组之间在测量的任何结局中均未发现显著差异。最值得注意的是，平均术后疼痛评分 （VAS，2.26 vs 2.7;p = 0.34）、术后使用的总 MME （11.73 vs 9.98 MME;p = 0.71） 和术后出院日 （4.00 vs 3.88 天;p = 0.82） 没有差异。结论 我们的研究结果表明，使用 LB 与术后疼痛或功能的显著改善无关，也与股骨颈骨折髋关节置换术后住院时间缩短无关。鉴于 LB 的成本高于标准的术后疼痛方式，因此值得质疑其在老年髋部骨折中的应用。证据级别 治疗 I 级 . 有关证据级别的完整描述，请参阅作者说明。