The use of exparel (liposomal bupivacaine) to manage postoperative pain in unilateral total knee arthroplasty patients

J Arthroplasty. 2015 Feb;30(2):325-9. doi: 10.1016/j.arth.2014.09.004. Epub 2014 Sep 16.


Efforts continue to improve pain after total knee arthroplasty (TKA) in order to allow for accelerated rehabilitation. The purpose of this study was to evaluate pain control after TKA. A randomized prospective study of 80 consecutive patients was performed comparing Exparel versus femoral nerve block (FNB). Inpatient pain control was the primary outcome. Secondary outcome measures included ROM (extension and flexion), nausea and vomiting, narcotic consumption, ambulation distance, and length of stay (LOS). There were no statistically significant differences between the groups with regard to pain, nausea and vomiting, and narcotic consumption. The FNB group had greater flexion but the Exparel group had improved early ambulation and decreased LOS. Exparel provided similar pain relief to a FNB after TKA without compromising early rehabilitation.

Keywords: accelerated rehabilitation; femoral nerve block; liposomal bupivacaine; total knee arthroplasty.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anesthetics, Local / administration & dosage*
  • Arthroplasty, Replacement, Knee*
  • Bupivacaine / administration & dosage*
  • Female
  • Femoral Nerve / drug effects
  • Humans
  • Injections
  • Liposomes
  • Male
  • Middle Aged
  • Nerve Block*
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / prevention & control
  • Prospective Studies


  • Anesthetics, Local
  • Liposomes
  • Bupivacaine