Addition of liposomal bupivacaine in brachial plexus blocks: a systematic review and meta-analysis of randomized controlled trials
Pooled resultResult — go to the resultMD −1.04 95% CI −1.54 to −0.53Authors' conclusion
There is low-level evidence that liposomal bupivacaine in brachial plexus block may reduce pain intensity after upper limb surgery, but the clinical significance may be limited.
Study context
- Population
- Patients receiving brachial plexus block for upper limb surgery
- Participants
- 1,478 patients · 21 randomized controlled trials (RCTs)
- Comparison
- Liposomal bupivacaine vs Non-liposomal local anesthetic
- Outcome
- Resting pain scores (NRS, 0-10); MD of 1/10 = minimal clinically important difference
- Follow-up
- 24 hours after nerve block injection
Methodological detailsrandom effects model, Grading of Recommendations Assessment, Development, and Evaluation (GRADE)
- Random effects model
- GRADE
Pooled result
As reported in the abstract
MD
−1.04
95% CI −1.54 to −0.53
P < 0.001
Liposomal bupivacaine vs Non-liposomal local anesthetic
MD −1.04 (95% CI −1.54 to −0.53); P < 0.001
Further pooled results
Resting pain scores at 48 and 72 hours
- Statistically significant reduction with liposomal bupivacaine
Opioid consumption at 0-24, 25-48 and 49-72 hours
- Lower in the liposomal bupivacaine group with statistical significance
- P < 0.05
Safety
- Lower incidence of nausea with liposomal bupivacaine
Original publication
Addition of liposomal bupivacaine in brachial plexus blocks: a systematic review and meta-analysis of randomized controlled trials. Reg Anesth Pain Med. Published 23 July 2025. doi:10.
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