Background and Aims As part of multimodal analgesia techniques, regional anesthesia plays a crucial role in reducing opioids usage. The aim of our study was to analyze the efficacy of intraoperative ilioinguinal block with liposomal bupivacaine (IIB/LB) in reducing intra- and post-operative use of narcotics in lower extremities vascular surgeries.

Methods We reviewed the clinical data of 107 patients who underwent elective lower extremities vascular surgeries at our institution from January 2017 to December 2022. Patients were divided into two groups: Group I (n=41 [38%]) received an intraoperative IIB/LB; Group II (n=66 [62%]) did not receive regional anesthesia. Endpoints included procedural metrics, intra- and post-operative narcotic use at 12, 24, 48 and 72 hours after surgery.

Results Both groups had similar demographics and operative indications. Median dose of intraoperative opioids in IV morphine equivalents was lower for Group I versus Group II (22.5 ± 10.1 vs 28.4 ± 12.2, P=0.01). Median postoperative IV morphine equivalents were lower for Group I versus Group II (at 12h 81.5±36.1 vs 108.1±44.5, P <0.001; at 24h 88.5±45.3 vs 125.4± 54.9, P <0.001; at 48h 121.7±75.2 vs 161.8±78.6, P=0.02; at 72h

121.7±76.1 vs 199.8±109.4, P<0.001). There were no significant differences in mortality or major adverse events between the two groups.

Conclusions Ilioinguinal block with liposomal bupivacaine significantly reduced the intra- and post-operative opioids use up to 72 hours, and it should be considered as part of multimodal analgesia approach for infra-inguinal vascular surgeries.

Ethics Committee Approval