Study Evaluates Long-Acting Bupivacaine for Pain Relief During Knee Replacement  What are the main findings?

Response: We found that liposomal bupivacaine injected at the surgical side during knee replacement did not improve post-operative recovery, compared to those receiving bupivacaine hydrochloride alone. We saw no difference neither in the Quality of Recovery score at 72 hours, nor in the pain assessed using pain visual analogue scale area under the curve at 6 to 72 hours. The results of this study do not support the use of peri-articular liposomal bupivacaine for knee replacement. What should readers take away from your report?

Response: New and costly drugs do not necessarily provide additional benefit all the time and good quality research is needed to ensure that new medications are indeed effective both clinically as well as in terms of costs incurred. What recommendations do you have for future research as a result of this work?

Response: We need to work on achieving good pain relief in a reproducible and sustained fashion in patients undergoing a knee replacement. The drive to move away from use of opioids in the peri-operative period should be continued with aim of achieving “opioid-free” recovery. 

Disclosures: This study was primarily funded by National Institute for Health and Care Research (NIHR) and supported by Pacira Pharmaceuticals (who provided the drug for free and part-funded the study). 


Hamilton TW, Knight R, Stokes JR, et al. Efficacy of Liposomal Bupivacaine and Bupivacaine Hydrochloride vs Bupivacaine Hydrochloride Alone as a Periarticular Anesthetic for Patients Undergoing Knee Replacement: A Randomized Clinical Trial. JAMA Surg. Published online April 06, 2022. doi:10.1001/jamasurg.2022.0713


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Last Updated on April 23, 2022 by