Liposomal Bupivacaine, Plain Bupivacaine, and Saline for Transversus Abdominis Plane Blocks: The CLEVELAND Randomized Trial
Authors' conclusion
Single-shot, four-quadrant TAP blocks performed with liposomal bupivacaine, plain bupivacaine, or normal saline before incision for various open and laparoscopic abdominal procedures resulted in similar postoperative opioid consumption and pain scores at 24, 48, and 72 h.
Study context
- Population
- Patients having major abdominal surgery (e.g., colorectal, gynecological, hernia repairs)modified ITT cohort
- Participants
- 261 patients
- Comparison
- Liposomal bupivacaine vs Plain bupivacaine vs Placebo
- Liposomal bupivacainen = 89
- Plain bupivacainen = 84
- Placebon = 88reference
- Primary endpoint
- Coprimary: opioid consumption (milligram morphine equivalents (MME)) during the initial 24 postoperative h, and between 24 to 48 h after surgery
- Follow-up
- 24 h; 24 to 48 h
Methodological detailsblinded, three-arm, placebo-controlled
- Blinded
- Three-arm
- Placebo-controlled
Primary result
As reported in the abstract
Opioid requirements, first 24 h · first 24 h
Each group vs placeboRatio of geometric means (97.7% CI)P value
Liposomal bupivacaine
0.86(0.60–1.24)
P = 0.355Plain bupivacaine
0.91(0.63–1.32)
P = 0.578Secondary outcomes
Time to sensation return, pain scores, opioid requirements 48–72 h
- Similar across all groups, no significant differences
Original publication
Liposomal Bupivacaine, Plain Bupivacaine, and Saline for Transversus Abdominis Plane Blocks: The CLEVELAND Randomized Trial. Anesthesiology. Published 1 December 2025. doi:10.
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