Liposomal Bupivacaine Infiltration After Median Sternotomy in Pediatric Cardiac Surgery.

Abstract Objective : This study retrospectively ascertained whether liposomal bupivacaine (LB) injected subcutaneously after median sternotomy incisions in pediatric cardiac surgery patients is as efficacious as ON-Q PainBuster. Design : Retrospective cohort comparison Setting : Pediatric Hospital Participants : Cardiac surgery patients who were treated with LB for elective cardiac surgery Interventions : Patients received 4 mg/kg of LB admixed with 0.25% bupivacaine and 0.9% normal saline. These patients were compared with an age- and procedure-matched control group of similar size treated with the ON-Q Pain Buster pump (ON-Q); continuous infusion 0.25% bupivacaine via subcutaneous catheter. Total analgesics used and route, other analgesics or sedatives, and pain scores (first 24 h and cumulative) were tracked for 96 h post-surgery. Measurements and Main Results : A total of 222 patients were equally divided among the two groups. Overall, the median (interquartile range) age was 6.5 (3.8–12.7) years. Unadjusted analysis suggested that patients in the LB group were administered a significantly higher dose of intravenous acetaminophen (77.4 vs 60.0 mg/kg; p Conclusions : LB is at least as effective as the ON-Q is for providing analgesia after median sternotomy incision in children.