This study evaluates the tolerability and efficacy of preoperative dorsal penile nerve
block with Exparel plus bupivacaine hydrochloride in children>6 years old undergoing
ambulatory urologic surgery. We demonstrate that the drug combination is well-tolerated,
with appropriate analgesic efficacy in the recovery room as well as at 48-hour and
10-14 day follow-up periods. These preliminary data justify the need to perform a
prospective, randomized trial comparing Exparel plus bupivacaine hydrochloride to
other common local anesthetic regimens used in pediatric urologic surgery.
Abbreviations:
Exparel (Liposomal bupivacaine), PACU (Post-anesthesia care unit), FLACC (Face, legs, activity, cry, consolability), PPPM (Parents' postoperative pain measure), NPS (Numerical pain score), OMEQ (Oral morphine equivalents)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Updates on wound infiltration use for postoperative pain management: a narrative review.J Clin Med. 2021; 10: 4659https://doi.org/10.3390/jcm10204659
- Peripheral nerve blocks in the management of postoperative pain: challenges and opportunities.J Clin Anesth. 2016; 35: 524-529https://doi.org/10.1016/j.jclinane.2016.08.041
- A multicenter study to evaluate the pharmacokinetics and safety of liposomal bupivacaine for postsurgical analgesia in pediatric patients aged 6 to less than 17 years (PLAY).J Clin Anesth. 2021; 75110503https://doi.org/10.1016/j.jclinane.2021.110503
Pacira Biosciences. Pacira announces FDA approval of supplemental new drug application for Exparel® (Bupivacaine liposome injectable suspension) in pediatric patients. 〈https://investor.pacira.com/news-releases/news-release-details/pacira-announces-fda-approval-supplemental-new-drug-0〉.
- Postoperative pain and analgesia administration in children after urological outpatient procedures.J Pediatr Urol. 2018; 14: 171.e1-171.e6https://doi.org/10.1016/j.jpurol.2017.11.014
- 141 Use of dorsal nerve block with bupivacaine liposome injectable suspension (Exparel) for pain management following Three-Piece Penile Prosthesis Surgery.J Sex Med. 2016; 13: S66https://doi.org/10.1016/j.jsxm.2016.02.147
Dosing-Administration Instructions for Exparel(R) in Pediatric Patients. Pacira Biosciences Inc. 〈https://www.exparel.com/hcp/specialty/pediatrics〉.
- Inconsistent and excessive opioid prescribing after common pediatric surgical operations.J Pediatr Surg. 2019; 54: 1427-1431
- Opioid use after pediatric urologic surgery: is it really needed.Urology. 2021; 158: 184-188https://doi.org/10.1016/j.urology.2021.04.012
- Efficacy of liposomal bupivacaine and bupivacaine hydrochloride vs bupivacaine hydrochloride alone as a periarticular anesthetic for patients undergoing knee replacement: a randomized clinical trial.JAMA Surg. 2022; 157: 481-489https://doi.org/10.1001/jamasurg.2022.0713
Article info
Publication history
Published online: March 28, 2023
Accepted:
January 30,
2023
Received:
December 11,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Financial Disclosure: The authors have no conflicts of interest to disclose. This study was internally funded by the Robert Jeffs, MD Department of Pediatric Urology at Johns Hopkins Hospital.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
