Healthcare Economic Information (HCEI) Studies

The clinical and economic value of EXPAREL has been evaluated in large real-world database analyses in both inpatient and outpatient settings.

Click on a study below to see how EXPAREL performed

For additional scientific information regarding EXPAREL, please visit medinfo.pacira.com or call (855) 793-9727.

The following studies were selected based on predefined criteria, including publication date (2018 or later), and prospectively designed studies that evaluated clinical and economic outcomes in the inpatient or outpatient settings for a variety of surgical procedures.

Inpatient

EXPAREL vs bupivacaine in TKA
See the inpatient TKA study
Investigator-initiated
Impact of EXPAREL vs non-EXPAREL protocol in inpatient THA
See the inpatient THA study
Investigator-initiated

Outpatient

EXPAREL vs non-EXPAREL protocol in TKA ASC surgeries
See the outpatient TKA study
EXPAREL in outpatient spine surgery
See the outpatient spine surgery study
Clinical and economic impact of EXPAREL in TSA
See the TSA study
Investigator-initiated

ASC, ambulatory surgical center; THA, total hip arthroplasty; TKA, total knee arthroplasty; TSA, total shoulder arthroplasty.

Additional Studies

Procedure Article
Total Knee Arthroplasty (TKA) Adductor canal block vs liposomal bupivacaine periarticular injection in total knee arthroplasty: a randomized controlled trial

Than J, et al. 2021
Total Hip Arthroplasty Impact of liposomal bupivacaine on opioid use, hospital length of stay, discharge status, and hospitalization costs in patients undergoing total hip arthroplasty

Asche C, et al. 2019
Sleeve Gastrectomy Liposomal bupivacaine for sleeve gastrectomy is associated with improved opioid outcomes and lower odds of opioid use disorder: claims-based analysis

Gould J, et al. 2024
Colorectal Real-world data on liposomal bupivacaine and inpatient hospital costs after colorectal surgery

Tran J, et al. 2022
Abdominal Economic outcomes and incidence of postsurgical hypotension with liposomal bupivacaine vs epidural analgesia in abdominal surgeries

Holtz M, et al. 2022
A cost-minimization analysis evaluating the use of liposomal bupivacaine in reconstructive plastic surgery procedures

Little A, et al. 2019
Cardiothoracic Pediatrics Effectiveness of liposomal bupivacaine compared with standard-of-care measures in pediatric cardiothoracic surgery: a retrospective cohort study

Tirotta C, et al. 2021
Cardiac Surgery via Median Sternotomy Superficial parasternal intercostal plane blocks with liposomal bupivacaine did not significantly reduce opioid use after cardiac surgery: a randomized clinical trial

Simon E, et al. 2025
Procedure Article
Spine Surgery Effects of liposomal bupivacaine on opioid use and healthcare resource utilization after outpatient spine surgery: a real-world assessment

Berven S, et al. 2024
Total Shoulder Arthroplasty (TSA) Randomized clinical trial comparing mixed liposomal bupivacaine vs. continuous catheter for interscalene block during shoulder arthroplasty: a comparison of analgesia, patient experience, and cost

Panchamia J, et al. 2025
Multiple Impact of liposomal bupivacaine and provider choice on opioid use and service outcomes in Medicare outpatient surgical patients

Dobson A, et al. 2021
Effects of liposomal bupivacaine (LB) and provider experience with LB on service utilization, clinical outcomes, and Medicare expenditures among fee-for-service (FFS) beneficiaries

Pal S, et al. 2025
Total Knee Arthroplasty (TKA) Real-world impact of treatment with liposomal bupivacaine on healthcare resource utilization, opioid consumption, and cost among patients undergoing total knee arthroplasty in ambulatory surgical settings in the United States

Lin J, et al. 2025
Procedure Article
Flap breast reduction Liposomal bupivacaine analgesia in deep inferior epigastric perforator flap breast reconstruction: a retrospective cohort study

Knackstedt R, et al. 2024
Colorectal resection Real-world assessment of longitudinal opioid use and healthcare resource utilization in patients undergoing colorectal resection

Schwartz G, et al. 2024
Procedure Article (poster presentation)
Total Knee Arthroplasty (TKA) Intraoperative Liposomal Bupivacaine Is Associated With Improved Pain, Opioid Use, Functional, and Length of Stay Outcomes After Total Knee Arthroplasty: Real-world Evidence

Ng M, et al. 2025
Important Safety Information

Indication

EXPAREL® (bupivacaine liposome injectable suspension) is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block.

Important Safety Information

  • EXPAREL is contraindicated in obstetrical paracervical block anesthesia
  • Adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via infiltration were nausea, constipation, and vomiting; adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via nerve block were nausea, pyrexia, headache, and constipation
  • Adverse reactions with an incidence greater than or equal to 10% following EXPAREL administration via infiltration in pediatric patients six to less than 17 years of age were nausea, vomiting, constipation, hypotension, anemia, muscle twitching, vision blurred, pruritus, and tachycardia
Important Safety Information
Important Safety Information

Indication

EXPAREL® (bupivacaine liposome injectable suspension) is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block. Safety and efficacy have not been established in other nerve blocks.

Important Safety Information

  • EXPAREL is contraindicated in obstetrical paracervical block anesthesia
  • Adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via infiltration were nausea, constipation, and vomiting; adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via nerve block were nausea, pyrexia, headache, and constipation
  • Adverse reactions with an incidence greater than or equal to 10% following EXPAREL administration via infiltration in pediatric patients six to less than 17 years of age were nausea, vomiting, constipation, hypotension, anemia, muscle twitching, vision blurred, pruritus, and tachycardia
  • Do not admix lidocaine or other non-bupivacaine local anesthetics with EXPAREL. EXPAREL may be administered at least 20 minutes or more following local administration of lidocaine
  • EXPAREL is not recommended to be used in the following patient populations: patients <6 years old for infiltration, patients younger than 18 years old for nerve blocks, and/or pregnant patients
  • Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease

Warnings and Precautions Specific to EXPAREL

  • Avoid additional use of local anesthetics within 96 hours following administration of EXPAREL
  • EXPAREL is not recommended for the following types or routes of administration: epidural, intrathecal, regional nerve blocks other than interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and adductor canal block, or intravascular or intra-articular use
  • The potential sensory and/or motor loss with EXPAREL is temporary and varies in degree and duration depending on the site of injection and dosage administered and may last for up to 5 days, as seen in clinical trials

Warnings and Precautions for Bupivacaine-Containing Products

  • Central Nervous System (CNS) Reactions: There have been reports of adverse neurologic reactions with the use of local anesthetics. These include persistent anesthesia and paresthesia. CNS reactions are characterized by excitation and/or depression
  • Cardiovascular System Reactions: Toxic blood concentrations depress cardiac conductivity and excitability, which may lead to dysrhythmias, sometimes leading to death
  • Allergic Reactions: Allergic-type reactions (eg, anaphylaxis and angioedema) are rare and may occur as a result of hypersensitivity to the local anesthetic or to other formulation ingredients
  • Chondrolysis: There have been reports of chondrolysis (mostly in the shoulder joint) following intra-articular infusion of local anesthetics, which is an unapproved use
  • Methemoglobinemia: Cases of methemoglobinemia have been reported with local anesthetic use

Please refer to full Prescribing Information.