Research Mentor Name
Khaled Saleh
Research Mentor Email Address
kjsaleh@gmail.com
Institution / Department
Wayne State University School of Medicine
Document Type
Research Abstract
Research Type
clinicalresearch
Graduate Level Research
no
Abstract
Title: Comparative Effectiveness of Liposomal Bupivacaine and Regional Nerve Blocks for Analgesia After Total Knee Arthroplasty
Introduction: Liposomal bupivacaine (Exparel) has been adopted in total knee arthroplasty (TKA) as a long-acting local anesthetic. However, its comparative effectiveness against standard regional anesthesia techniques, such as femoral or adductor canal block, remains insufficiently defined. This study evaluates postoperative analgesic utilization following TKA among patients receiving Exparel, regional blocks, or no regional intervention, using matched cohorts from a large national dataset.
Methods: Patients who underwent primary TKA between January 1, 2005 and January 1, 2025 were retrospectively identified from a multi-institutional electronic medical record–derived database. Three cohorts were constructed: (1) patients receiving intraoperative Exparel, (2) patients receiving femoral or adductor canal blocks without Exparel, and (3) patients receiving neither. A 1:1:1 propensity score–matched analysis was conducted, balancing age, sex, race, and comorbidities. Postoperative prescription fills for opioids, NSAIDs, and gabapentinoids were assessed at 14, 30, and 90 days.
Results: At 14 days, opioid use was 8.1% (Exparel), 6.8% (Block), and 7.1% (Control), with Exparel slightly higher versus Block (RR 1.22) and Control (RR 1.15). NSAID use was modestly higher in Exparel and Block (0.9% vs 0.5% Control). By 30 and 90 days, opioid use was similar across groups, with only minor differences in mean prescription fills. NSAID and gabapentin use remained slightly elevated in Exparel and Block cohorts through 90 days.
Conclusion: Intraoperative administration of liposomal bupivacaine during TKA was associated with modest reductions in opioid and NSAID prescription volumes compared to controls but offered no clear advantage over femoral or adductor canal block. These findings suggest that while Exparel contributes to multimodal analgesia, its clinical benefits may be comparable to those of regional anesthesia in TKA.
Disciplines
Medicine and Health Sciences | Orthopedics
Recommended Citation
Makled, Ahmed; Ghafarian, Amir; Saad, Jawad; Zahriyeh, Muhammed; Wajahath, Muaaz; and Saleh, Khaled, "Comparative Effectiveness of Liposomal Bupivacaine and Regional Nerve Blocks for Analgesia After Total Knee Arthroplasty" (2026). Medical Student Research Symposium. 504.
https://digitalcommons.wayne.edu/som_srs/504