Conference Coverage

Liposomal Bupivacaine Benefits Vary by Procedure, Systematic Review Finds

Edited by:
Anthony Calabro, MA

Key Highlights

  • The systematic review included 24 studies and 1,735 patients undergoing oral and maxillofacial procedures.
  • Overall satisfaction with postoperative pain control was 78.4% with liposomal bupivacaine versus 55.5% with standard bupivacaine or no adjunct analgesia.
  • In orthognathic surgery, liposomal bupivacaine was associated with a 43.8% reduction in reported pain scores and an approximately 5.8% shorter hospital stay.
  • The review found no significant differences in pain, length of stay, or readmission after oncologic resection with free flap reconstruction.

A systematic review presented at the 2026 AAOMS Annual Meeting in Seattle, WA, found that liposomal bupivacaine was associated with higher patient satisfaction and improved postoperative pain outcomes in selected oral and maxillofacial procedures. The reported benefits varied by procedure and were not observed in oncologic resections with free flap reconstruction.

Following PRISMA guidelines, researchers searched PubMed, MEDLINE, Embase, Scopus, and Google Scholar for studies published through February 28, 2026, that compared standard and liposomal bupivacaine in oral and maxillofacial surgery. Studies of other local anesthetics, incomplete manuscripts, and conference abstracts without full data were excluded. Extracted outcomes included pain scores, opioid use, patient satisfaction, hospital length of stay, and postoperative outcomes.

Study Findings

The review included 24 studies with 1,735 patients. Liposomal bupivacaine was used most often after orthognathic surgery and third molar extraction and less often after facial trauma procedures and microsurgical free flap reconstruction. Among patients undergoing dentoalveolar procedures, including third molar extraction, satisfaction was higher with liposomal bupivacaine than with standard bupivacaine or no local anesthetic adjunct (81.9%; P = .001). Across procedures, satisfaction with postoperative pain control was 78.4% with liposomal bupivacaine versus 55.5% with standard bupivacaine or no adjunct analgesia (P = .005).

For orthognathic surgery, liposomal bupivacaine was associated with a 43.8% reduction in reported pain scores and an approximately 5.8% reduction in hospital length of stay compared with standard bupivacaine. No statistically significant differences in postoperative pain, hospital length of stay, or readmission were observed after oncologic resection with free flap reconstruction.

Clinical Implications

According to the study authors, liposomal bupivacaine may improve pain control, reduce opioid use, shorten hospitalization, and increase satisfaction in selected oral and maxillofacial procedures. They cautioned that benefits may be procedure-dependent and called for large prospective studies to assess long-term outcomes, cost-effectiveness, facial trauma management, and microvascular reconstruction.

Expert Commentary

"Liposomal bupivacaine appears to provide improved postoperative pain control in oral and maxillofacial surgery and may contribute to reduced opioid consumption, shorter hospital length of stay, and greater patient satisfaction in selected procedures," the researchers concluded.

Reference
Rais MA, Issa AM, Boudjellal HA. Is the use of liposomal bupivacaine in oral and maxillofacial surgery associated with shorter hospital length of stay and greater patient satisfaction? A comparative systematic review. Poster presented at: 108th American Association of Oral and Maxillofacial Surgeons Annual Meeting, Scientific Sessions and Exhibition; September 30-October 3, 2026; Seattle, WA. Accessed September 14, 2026. https://aaoms.org/education-meetings/meetings/2026-annual-meeting/