Table 2.

Summary of researches with positive efficacy of EXPAREL

Reference number	Route	Comparison	Surgery	Primary outcome	Results
[59]	Injection into the trocar path and vaginal incision	Saline	Retropubic midurethral sling	VAS pain score 4 hours after discharge home	Pain score was lower in intervention group (n = 54, 3.5), than in control group (n = 55, 3.5) (p = 0.014)
[60]	Interscalene block	Continuous interscalene nerve block with plain bupivacaine	Shoulder arthroplasty	Pain assessment up to 24h after surgery, all doses and times of narcotics during the inpatient stay	No significant difference for primary end point; LB group (n = 34) had higher American Shoulder and Elbow Surgeons score (74.5) and Penn Shoulder Score (72.3) than control (n = 32, 59.7, 56.3) at final follow-up
[61]	Posterior intercostal nerve block	Thoracic EPI	Lung resection	Perioperative morbidity, pain scores and narcotic requirements	Non-inferior analgesia of LB group compared to control (n = 54 respectively)
[62]	Multilevel intercostal nerve block	EPI	Open thoracotomy	Mean pain score on POD 1, 2, 3, supplemental narcotic utilization, total length of hospital stays	LB group (n = 53) showed lower mean pain score on day 1 (p < 0.04) and 3 (p < 0.04) compared to EPI (n = 32), the length of hospital stay was longer in LB group (7.4 days) compared to EPI group (9.3 days) (p < 0.05)
[63]	Intraoperative intrathoracic intercostal nerve rib blocks	Thoracic with bupivacaine hydrochloride	Video-assisted thoracoscopic pulmonary resection	Pain score, postoperative opioid medication	LB group had significantly lower VAS scores (n = 143, 3.9 versus 4.5, p < 0.05), decreased postoperative opioid medication (morphine equivalent dose during the first 3 days: 344.5 versus 269.5, p < 0.05) than control (n = 237)
[64]	Post-incisional TAP	Plain bupivacaine infiltration	Bariatric Surgery	All narcotics used	LB group (n = 233, 44.5mg) required less narcotic than control group for entire hospital stay (n = 243, 78.0mg) (p = 0.00001)
[65]	TAP	Pain catheter (OnQ)	Delayed unilateral deep inferior epigastric perforator reconstruction	Intravenous, oral and total narcotics utilization	LB group (n = 6) compared to OnQ group (n = 6) used 19.3 mg vs. 29.6 mg intravenously, 40.9mg vs. 53.2mg in total (p = 0.005, < 0.001= respectively
[66]	TAP	Intravenous patient control analgesia (IV PCA), EPI	Major lower abdominal surgery	Total postoperative IV morphine-equivalent dose of opioid and time-weighted average NRS pain scores	TAP infiltration (n = 108) was noninferior to EPI (n = 108)on both primary outcomes (p < 0.001)
[67]	TAP	0.25% bupivacaine injection	Laparoscopic hand-assisted donor nephrectomy	Maximal pain scores, opioid consumption at 24, 48, 72 h postoperatively	LB group (n = 30) compared with control (n = 29) median, showed lower pain scores on 24–48 h after injection (5 vs. 6, p = 0.009); on 48–72 h after injection (3 vs. 5, p = 0.02); and fewer opioid use on 48–72 h after injection (105 vs. 182, p = 0.03)

POD postoperative day, VAS visual analog scale, NRS numeric rating scale, LB liposomal bupivacaine, EPI epidural analgesia, TAP transversus abdominis plane block