What question did this study set out to answer?

The aim is to determine if liposomal bupivacaine offers better analgesia than ropivacaine in patients undergoing lumbar fusion surgery.

April 25, 2026Open Access

Liposomal Bupivacaine Infiltration and Postoperative Pain Outcomes in Lumbar Fusion: A Prospective Randomized Controlled Trial

Puntos clave

The aim is to determine if liposomal bupivacaine offers better analgesia than ropivacaine in patients undergoing lumbar fusion surgery.
Single-center randomized controlled trial with 94 patients undergoing multi-segmental posterior lumbar fusion.
Participants were randomized to receive either liposomal bupivacaine or ropivacaine for wound infiltration.
Outcomes measured included pain scores, opioid use, recovery quality, sleep quality, length of stay, and adverse events.
No significant difference in the primary endpoint of 24-hour resting pain scores between the two groups.
Rescue opioid use was similar in both groups within 48 hours.
No notable differences in recovery quality, sleep quality, length of stay, or adverse events.

Resumen

Shi-Jing Zhang,1, Xin Lu,2, Tian-Xiao Liu,1 Qing Liu,1 Yu-Bo Xie1,3 1Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Peopleâs Republic of China; 2Department of Anesthesiology, Guangxi Hospital Division of the First Affitiated Hospital, Sun Yat-sen University, Nanning, Peopleâs Republic of China; 3Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital These authors contributed equally to this workCorrespondence: Yu-Bo Xie, Email 1157817791@qq.com Qing Liu, Email lhrnas2017@outlook.comBackground: Postoperative pain after lumbar fusion may impair coughing and early mobilization. Whether liposomal bupivacaine provides better analgesia than ropivacaine infiltration in this setting remains unclear.Methods: In this single-center randomized controlled trial, 94 patients undergoing multi-segmental posterior lumbar fusion were randomized to LB+B or RH wound infiltration. Outcomes included resting and cough-induced pain scores, rescue opioid use, recovery and sleep quality, length of stay, and adverse events.Results: The prespecified primary endpoint (24-hour resting VAS) did not differ between groups. In baseline-adjusted longitudinal GEE models, neither the overall treatment effect nor the treatment-by-time interaction was statistically significant for resting or dynamic pain. Model-based estimates indicated only modest between-group differences, which were below commonly cited minimal clinically important difference thresholds. Rescue opioid use over 48Â hours was similar between groups, and no differences were observed in rescue analgesia, recovery quality, sleep quality, length of stay, or adverse events.Conclusion: In this randomized trial, LB+B did not show a significant overall analgesic advantage over ropivacaine infiltration and was not associated with opioid-sparing or recovery benefits.Clinical Trial Identifier: The date of first registration in 19/07/2023 ChiCTR2300073714. https://www.chictr.org.cn/.Keywords: liposomal bupivacaine, ropivacaine hydrochloride, postoperative pain, lumbar fusion

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