Efficacy of liposomal bupivacaine for pain control in shoulder surgery: a systematic review and meta-analysis

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“…In an RCT comparing liposomal bupivacaine plus bupivacaine for interscalene nerve block with bupivacaine alone in arthroscopic rotator cuff repair, Flaherty et al found that adding liposomal bupivacaine did not reduce opioid consumption or reduce maximum VAS pain scores at 24 hours (1 in the liposomal bupivacaine group compared with 3 in the bupivacaine-only group; p = 0.02) or at 72 hours (3 in the liposomal bupivacaine group compared with 4 in the bupivacaine-only group; p = 0.03), which was a significant change but not the MCID, but adding liposomal bupivacaine did increase the quality-of-recovery score at 72 hours (p = 0.01) 40 . Similarly, a systematic review and meta-analysis of 11 RCTs of 846 patients comparing liposomal bupivacaine with conventional bupivacaine or ropivacaine peripheral nerve blocks for shoulder surgery showed no significant difference in VAS pain scores at 24 and 48 hours, opioid consumption, length of hospital stay, or complications 43 .…”

“…Considerable efforts have been made to utilize nonopioid medication in the management of pain following painful orthopaedic procedures. Many studies have been performed to determine the efficacy of peripheral nerve blocks and multimodal pain regimens with respect to the reduction of opioid consumption after procedures involving the hip 38 , knee 39 , and shoulder [40][41][42][43] .…”

Pediatric regional anesthesiology: a narrative review and update on outcome-based advances

“…During this time, innumerable case series and investigations comparing liposomal with plain bupivacaine have been conducted 34,102–107 . However, the authors of a systematic review and meta-analysis published in 2021 point out that many of the studies with positive findings for liposomal bupivacaine have industry-sponsored authors and/or gaps in data precluding sound conclusions from being made 104,108 .…”

“…During this time, innumerable case series and investigations comparing liposomal with plain bupivacaine have been conducted. 34,[102][103][104][105][106][107] However, the authors of a systematic review and meta-analysis published in 2021 point out that many of the studies with positive findings for liposomal bupivacaine have industry-sponsored authors and/or gaps in data precluding sound conclusions from being made. 104,108 In fact, the manufacturer agreed to pay $3.5 million to resolve allegations of violating the False Claims Act by providing illegal kickbacks for physicians who used liposomal bupivacaine under the brand name Exparel.…”