The effect of liposomal bupivacaine for surgical wound infiltration: A meta-analysis of randomised controlled trials.

Abstract

Liposomal bupivacaine (LB) has consistently been considered a potential analgesic for surgical wound infiltration. However, the evidence of its analgesic effectiveness remains unclear. In this meta-analysis, we attempted to identify the potential clinical role of LB wound infiltration in different surgical procedures. Randomised controlled trials (RCTs) comparing LB with non-liposomal local anaesthetics and placebos were retrieved from six electronic databases. The primary outcome was cumulative morphine equivalent consumption within 24, 48, and 72 hours after surgery. Approximately 2659 patients from 22 studies were included in the meta-analysis. Compared to the control, LB-wound infiltration did not reduce the postoperative morphine consumption at 24 hours (weighted mean difference [WMD], -0.60 mg; 97.5% confidence interval [CI], -2.78 to 1.59 mg; P = 0.54), 48 hours (WMD, -1.00 mg; 97.5% CI, -3.23 to 1.24; P = 0.32) or 72 hours (WMD, 0.50 mg; 97.5% CI, -0.67 to 1.67; P = 0.33). Similarly, secondary outcome analysis did not reveal any additional benefits of LB in any other pain-related outcomes. LB was not associated with any adverse effects. Overall, LB does not appear to improve the postoperative analgesic, rehabilitation, or safety outcomes. Current evidence does not support the routine use of LB for wound infiltration following surgical procedures.

• Authors: Hua Jiang, Qiong Ma, Jing Dong, Xin Ye
• Journal: International wound journal (Int Wound J) Vol. 20 Issue 5 Pg. 1591-1608 (May 2023) ISSN: 1742-481X [Electronic] England
• PMID: 36345868 (Publication Type: Meta-Analysis, Journal Article)
• Copyright: © 2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.

Chemical References

• Analgesics
• Bupivacaine
• Liposomes
• Morphine Derivatives

Topics

• Humans
• Analgesics (therapeutic use)
• Bupivacaine
• Liposomes (therapeutic use)
• Morphine Derivatives (therapeutic use)
• Pain, Postoperative (drug therapy)
• Surgical Wound
• Randomized Controlled Trials as Topic