Evidence map›Paper›PMID 40693195›Full record

ReviewJournal of pain research2025

Clinical Effectiveness of Perineural Liposomal Bupivacaine is Not Superior to Bupivacaine Hydrochloride for the Prevention of Postoperative Pain in Orthopedic Surgery: A Systematic Review and Meta-Analysis with Trial Sequential Analysis.

Meixuan Wan, Xuan Liang, Jingwen Meng, Haiyao Wu, Chunhua Xi

Abstract readReview
In one paragraph

Review in Journal of pain research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Meixuan WanDepartment of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.
Xuan LiangDepartment of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.
Jingwen MengOperation Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.
Haiyao WuDepartment of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.
Chunhua XiDepartment of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: As a long-lasting local anesthetic, liposomal bupivacaine has become a part of certain multimodal analgesic regimens for acute postoperative pain. The objective of the present meta-analysis was to investigate the efficacy of liposomal bupivacaine in acute pain management after orthopedic surgery through peripheral nerve blocks and compare it with plain bupivacaine. Methods: The EMBASE, PubMed, Web of Science, Scopus databases, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews were searched for randomized controlled trials (RCTs) published in print or online up to 11 October 2024. The primary outcomes were NRS scores and opioid consumption at postoperative 24-72 hours. A minimum difference of 2.0 points on NRS scores or 30-mg in OME consumption was considered clinically relevant. Results: A total of 10 RCTs (782 patients) were finally included in the meta-analysis. There were significant differences in the mean NRS scores at postoperative 48 hours (MD = -0.86, 95% CI: [-1.19, -0.45], P < 0.001) and 72 hours (MD = -0.38, 95% CI: [-0.54, -0.21], P < 0.001). As regard to opioid consumption, there were statistical differences at postoperative 48 hours (MD = -5.51, 95% CI: [-9.97, -1.06], P = 0.020) and 72 hours (MD = -3.62, 95% CI: [-6.04, -1.21], P = 0.003). But none of the differences, including NRS scores and opioid consumption, met the prespecified thresholds for clinical relevance. Additional benefits of liposomal bupivacaine over plain bupivacaine were observed only in the nerve block duration (RR = 3.35, 95% CI: [1.92, 5.84], P < 0.001). Conclusion: The advantages of perineural liposomal bupivacaine over plain bupivacaine in providing analgesia after orthopedic surgery were statistically significant but not clinically relevant. Current evidence suggests that the existing RCTs are insufficient to support the idea that the perineural use of liposomal bupivacaine is clinically worthwhile in pain management after orthopedic surgery compared with plain bupivacaine.

Indexed as

liposomal bupivacainemeta-analysisorthopedic surgeryperipheral nerve blockpostoperative painsystematic review

Identifiers

PMID40693195
PMCPMC12277084

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.