Opioid-Sparing Pain Control in Outpatient Total Joint Arthroplasty.

Postoperative pain management is vital to promoting recovery and improving clinical outcomes. Although improved understanding of pain pathways has led to the development of varied approaches for controlling pain after surgery, some approaches are associated with potentially harmful side effects. Several lines of evidence have demonstrated that opioid analgesics can have unwanted adverse effects on patients having surgery. Similarly, risks associated with femoral nerve blocks have outweighed the benefits. Liposomal bupivacaine has shown efficacy in reducing the need for opioid analgesics and nerve blocks. Specifically, use of liposomal bupivacaine in a multimodal analgesia plan resulted in superior clinical and economic parameters in total joint arthroplasty. These advantages of liposomal bupivacaine are valuable in the current health care environment and in outpatient joint arthroplasty, in which highly effective opioid-sparing pain management is a prerequisite. Thus, liposomal bupivacaine can be used to reduce the burden of opioids and facilitate same-day discharge, thereby addressing some of the challenges associated with implementing short-stay or outpatient total joint arthroplasty.