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Background <p>Liposomal bupivacaine (LB) is increasingly integrated into Enhanced Recovery After Surgery (ERAS) protocols for abdominally based autologous breast reconstruction. This meta-analysis evaluated LB effectiveness through two contrasts: the incremental effect (ERAS using LB vs. regular anesthetics [RA]) and the package effect (ERAS using LB vs. pre-ERAS care).</p> Methods <p>PubMed, Embase, Cochrane Library, and Web of Science were searched for studies evaluating LB and RA within ERAS, and pre-ERAS care in transversus abdominis plane (TAP) blocks for abdominally based autologous breast reconstruction. Data were synthesized using a random-effects meta-analysis and reported as mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI).</p> Results <p> Twelve studies involving 1,890 patients were included in the systematic review and meta-analysis. LB showed modest incremental benefit, reducing cumulative pain scores vs. RA (MD − 0.49; 95% CI − 0.87 to − 0.11; <i>p</i> = 0.01), but no significant effect on opioid use or length of stay. ERAS incorporating LB significantly reduced opioid consumption (SMD − 1.40; 95% CI -1.87 to -0.93; <i>p</i> &lt; 0.00001) and hospital stay (MD -0.89; 95% CI -1.27 to -0.51; <i>p</i> &lt; 0.00001) compared with pre-ERAS care.</p> Conclusions <p>LB adds limited benefit within ERAS but reflects the overall efficacy of ERAS implementation.</p> <p><b>Level of Evidence:</b> not gradable.</p>

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Liposomal bupivacaine transversus abdominis plane block in ERAS vs. Pre-ERAS protocols for abdominally based autologous breast reconstruction: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年12月5日

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  • Iqbal Farhan Sayudo,
  • Teuku Nanda Putra,
  • Syamsul Rizal,
  • Mirnasari Amirsyah,
  • Muhammad Ikhsan,
  • Pratidina Wulandari,
  • Agustina Indah Garnasih,
  • Rafae Ali Khan,
  • Hussam Akram,
  • Yami Bhaskar

摘要

Background

Liposomal bupivacaine (LB) is increasingly integrated into Enhanced Recovery After Surgery (ERAS) protocols for abdominally based autologous breast reconstruction. This meta-analysis evaluated LB effectiveness through two contrasts: the incremental effect (ERAS using LB vs. regular anesthetics [RA]) and the package effect (ERAS using LB vs. pre-ERAS care).

Methods

PubMed, Embase, Cochrane Library, and Web of Science were searched for studies evaluating LB and RA within ERAS, and pre-ERAS care in transversus abdominis plane (TAP) blocks for abdominally based autologous breast reconstruction. Data were synthesized using a random-effects meta-analysis and reported as mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI).

Results

Twelve studies involving 1,890 patients were included in the systematic review and meta-analysis. LB showed modest incremental benefit, reducing cumulative pain scores vs. RA (MD − 0.49; 95% CI − 0.87 to − 0.11; p = 0.01), but no significant effect on opioid use or length of stay. ERAS incorporating LB significantly reduced opioid consumption (SMD − 1.40; 95% CI -1.87 to -0.93; p < 0.00001) and hospital stay (MD -0.89; 95% CI -1.27 to -0.51; p < 0.00001) compared with pre-ERAS care.

Conclusions

LB adds limited benefit within ERAS but reflects the overall efficacy of ERAS implementation.

Level of Evidence: not gradable.