Table 2.
Characteristics of included studies.
| References | Study type | Surgery type | Sample size | Mean age | LB protocol | RB protocol | Analgesia regimen | ||
|---|---|---|---|---|---|---|---|---|---|
| LB | RB | LB | RB | ||||||
| Nedeljkovic et al. (30) | RCT | Cesarean section | 91 | 83 | 34* | 33* | US-guided block with 266 mg of LB and 50 mg RB diluted in 60 ml of saline | US-guided block with 50 mg RB diluted in 60 ml of saline | Epidural anesthesia with 1.4–1.6 ml of hyperbaric 0.75% RB with 150 μg of morphine and 15 μg of fentanyl. Postoperatively acetaminophen and ibuprofen for up to 72 h or until hospital discharge |
| Wong et al. (31) | RCT | Roux-en-Y gastric bypass, Sleeve gastrectomy, or sleeve-to-bypass conversion | 75 | 73 | 42.1 ± 9.8 | 39.4 ± 10.9 | Laparoscopic block with 20 ml of LB, 0.25% bupivacaine, 100 ml saline | Laparoscopic block with 50 ml of 0.25% RB, 100 ml saline | Fentanyl PCA at 10 μg at a maximum of every 10 min × 24 h, acetaminophen with codeine elixir (360 mg/36 mg) oral × 4 h, ketorolac 30 mg IV × 6 h, and dilaudid 0.4 mg IV × 3 h or morphine 4 mg IV × 4 h as needed for breakthrough pain |
| Ha et al. (32) | RCT | Abdominally based autologous breast reconstruction | 22 | 22 | 49 ± 9.2 | 49 ± 10 | Under direct vision with 266 mg of LB diluted in 30 ml of saline | Under direct vision with 75 mg of RB diluted in 30 ml of saline | Preoperative paravertebral blocks with 15 ml of 0.5% bupivacaine. Acetaminophen, celecoxib, OxyContin before the blocks and postoperatively for preemptive analgesia. On day of surgery, 1 mg of hydromorphone available every hour for rescue analgesia. From day 1, 5–10 mg of oral oxycodone x 3 h, and 0.5 mg of hydromorphone IV × every hour as needed for breakthrough pain |
| Guerra et al. (35) | Prospective non-randomized | Laparoscopic colectomy | 50 | 50 | 57.88 ± 1.56 | 58.37 ± 1.91 | Laparoscopic block with 20 ml LB, 40 ml RB and 20 ml saline | Laparoscopic block with 60 ml RB and 20 ml saline | Scheduled oral acetaminophen, ibuprofen, and gabapentin. IV Dilaudid or morphine ordered for breakthrough pain. |
| Stokes et al. (36) | Retrospective | Colorectal surgery | 303 | 104 | 53.8 ± NR | 51.8 ± NR | US-guided block with 10 ml of LB with 5 ml of 0.25% RB on each side | US-guided block with 20 ml of 0.25% RB on each side | Opioids allowed postoperatively. Ketorolac or ibuprofen ordered as needed every 6 h up to 5 days |
| Hutchins et al. (33) | RCT | Donor nephrectomy | 30 | 29 | 41 ± 12.5 | 38 ± 12.6 | US-guided block with 10 ml of 1.3% LB with 20 ml saline on each side | US-guided block with 30 ml of 0.25% RB with 1:200,000 epinephrine | IV or oral opioids and ketorolac given when patients experienced moderate to severe postoperative pain. IV opioids used were fentanyl, hydromorphone or morphine, and oral opioids were hydromorphone, hydrocodone or oxycodone. |
| Hutchins et al. (34) | RCT | Robotic hysterectomy | 28 | 30 | 60.5 ± 10.8 | 56.8 ± 10 | US-guided block with 10 ml of 1.3% LB with 20 ml saline on each side | US-guided block with 30 ml of 0.25% RB with 1:200,000 epinephrine | Hydromorphone or fentanyl at the discretion of registered nurse anesthetist or anesthesiology resident |
*
Median age.
RCT, randomized controlled trial; US, ultrasound; LB, liposomal bupivacaine; RB, regular bupivacaine; PCA, patient controlled anesthesia; IV, intravenous.