Liposome bupivacaine for improvement in economic outcomes and opioid burden in GI surgery: IMPROVE study pooled analysis

Stephen M. Cohen, Jon D. Vogel, Jorge E. Marcet, Keith A. Candiotti

Research output: Contribution to journalArticle

18 Scopus citations


Postsurgical pain management remains a significant challenge. Liposome bupivacaine, as part of a multimodal analgesic regimen, has been shown to significantly reduce postsurgical opioid consumption, hospital length of stay (LOS), and hospitalization costs in gastrointestinal (GI) surgery, compared with intravenous (IV) opioid-based patient-controlled analgesia (PCA). Pooled results from open-label studies comparing a liposome bupivacaine-based multimodal analgesic regimen with IV opioid PCA were analyzed. Patients (n=191) who underwent planned surgery and received study drug (IV opioid PCA, n=105; multimodal analgesia, n=86) were included. Liposome bupivacaine-based multimodal analgesia compared with IV opioid PCA significantly reduced mean (standard deviation [SD]) postsurgical opioid consumption (38 [55] mg versus [vs] 96 [85] mg; P<0.0001), postsurgical LOS (median 2.9 vs 4.3 days; P<0.0001), and mean hospitalization costs (US$8,271 vs US$10,726; P=0.0109). The multimodal analgesia group reported significantly fewer patients with opioid-related adverse events (AEs) than the IV opioid PCA group (P=0.0027); there were no significant between-group differences in patient satisfaction scores at 30 days. A liposome bupivacaine-based multimodal analgesic regimen was associated with significantly less opioid consumption, opioid-related AEs, and better health economic outcomes compared with an IV opioid PCA-based regimen in patients undergoing GI surgery.

Original languageEnglish (US)
Pages (from-to)359-366
Number of pages8
JournalJournal of Pain Research
StatePublished - Jun 24 2014



  • Analgesia
  • Bupivacaine
  • Gastrointestinal surgery
  • Opioid analgesics
  • Postoperative pain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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