Liposomal bupivacaine in lower extremity arthroplasty: a comprehensive review
By
Fang, Yuang
Hu, Beilin
Mu, Guo
Yu, Hong
Zhou, Jun
April 6, 2026
Objective: To assess the efficacy and safety of liposomal bupivacaine (LB) in postoperative pain management for lower extremity joint arthroplasty.
Key Findings: LB resulted in a 35-50% reduction in 24-hour opioid requirements (pooled RR = 0.62; 95% CI: 0.32-0.89; p = 0.008). LB reduced hospital length of stay by an average of 0.5 days (MD = -0.5 days; 95% CI: -0.7 to -0.3; p < 0.001). LB enhanced early-phase analgesia with a 24-hour VAS reduction of 1.2 points (MD = -1.2 points; 95% CI: -1.5 to -0.9; p < 0.001). Interpretation: LB provides opioid-sparing effects and is used with adductor canal block in TKA procedures.
Limitations: Cost-effectiveness of LB varies by surgical procedure. No significant difference in analgesia was observed beyond 72 hours compared to controls. Conclusion: LB offers benefits in pain management, but its cost-benefit profile requires careful assessment.
