Double-Blinded Randomized Controlled Study Investigating the Efficacy of Exparel (Liposomal Bupivacaine) for Postoperative Pain Relief in Mandibular Third Molar Extractions
Summary
The most prevalent complaint after third molar extractions is pain. There have been many modalities and regimens developed to manage post-operative pain, such as modifications in surgical techniques, locally-applied medicaments, and oral analgesics. Recently, liposomal bupivacaine (Exparel) has been FDA approved for single-dose infiltration in the oral cavity in adults and children (6 years or older) to produce extended postsurgical local anesthesia. We hypothesize that the administration of liposomal bupivacaine (Exparel) at the end of third molar extractions will decrease postoperative pain and decrease narcotic use for pain management.
Timeline
- Start
- 2022-09-01
- Primary completion
- 2023-12-01
- Completion
- 2024-05-01
Outcome
Met primary endpoint
paper Pain was lower in the LB versus SB group on surgery day (NRS difference -0.75; P = .002) PMID 39900116 ↗
paper AUC analysis showed cumulative pain reduction for the LB group in comparison to the SB group through all 4 postoperative days for the overall cohort (average AUC0-96 difference 93.5, P = .005) PMID 39900116 ↗
Publications
- Background Lieblich SE, Danesi H. Liposomal Bupivacaine Use in Third Molar Impaction Surgery: INNOVATE Study. Anesth Prog. 2017 Fall;64(3):127-135. doi: 10.2344/anpr-64-02-03.
- Youn S, Scheker K, Sheridan S, Hayashi C, Pickering TA, Costandi J. Does Liposomal Bupivacaine Reduce Postoperative Pain Following Third Molar Extractions? A Double-Blinded Randomized Controlled Trial. J Oral Maxillofac Surg. 2025 May;83(5):592-600. doi: 10.1016/j.joms.2025.01.004. Epub 2025 Jan 17.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Bupivacaine | Other / unclassified | 3 ml | Other |
| Comparator | Epinephrine | Other / unclassified | — | Other |
Indications
No indication recorded.