Single-Shot Liposomal Bupivacaine Non-Inferior to Continuous Block After Knee Arthroplasty

This non-inferiority trial helps pain and perioperative pharmacists weigh a catheter-free liposomal bupivacaine block against continuous local anesthetic infusion for posterior knee pain after total knee arthroplasty.

liposomal bupivacainebupivacainecontinuous peripheral nerve blockparasacral ischial plane blocktotal knee arthroplastypostoperative painnon-inferiority trialregional anesthesiaopioid sparingmultimodal analgesia Pain / Palliative Care

Background Information

Liposomal bupivacaine equals infusion for knee pain, but less opioid use with infusion.

Effective pain management after total knee arthroplasty (TKA) can reduce opioid use and improve recovery. Comparing continuous bupivacaine infusion and liposomal bupivacaine helps guide treatment choices. Liposomal bupivacaine was non-inferior to continuous infusion for pain relief; however, continuous infusion had lower opioid consumption and improved early rehabilitation outcomes. While liposomal bupivacaine offers comparable pain control, continuous infusion may enhance rehabilitation and reduce opioid need, despite minor catheter-related issues. Liposomal bupivacaine matches infusion for pain relief, but infusion aids recovery and reduces opioids post-TKA.

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Authors: Pan X, Ye P, Xie Y, Chen Y, Fan H, Huang Y, Zheng C, Zheng X, Zheng T

Citation: Pan X, Ye P, Xie Y, et al. Analgesic Efficacy of Continuous Bupivacaine Infusion versus Liposomal Bupivacaine in Parasacral Ischial Plane Block After Total Knee Arthroplasty: An Open-Label, Randomized, Controlled, Non-Inferiority Study. Drug design, development and therapy. 2026;20:626404. doi:10.2147/DDDT.S626404

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

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