Liposomal Bupivacaine for Pain After Lumbar Fusion

Liposomal Bupivacaine for Acute Pain Management Following Posterior Lumbar Decompression and Fusion Surgery in Adults: A Prospective, Randomized Controlled Trial

Spine surgery often causes severe postoperative pain. Currently, our hospital routinely uses ropivacaine for local infiltration analgesia (lasting 6-8 hours). This study evaluates liposomal bupivacaine, a novel long-acting local anesthetic providing up to 72 hours of pain relief, in patients undergoing posterior lumbar spine surgery. Through a randomized controlled design, we will compare the two drugs' effects on pain control within 72 hours and opioid consumption. Both regimens are guideline-recommended and safe.

Inclusion Criteria:

• Age ≥18 years；
• ASA physical status class I-III；
• Scheduled for elective 1- or 2-level posterior lumbar surgery: Decompression (laminectomy/discectomy) and fusion with internal fixation

Exclusion Criteria:

• Chronic pain disorders requiring ≥30 mg oral morphine equivalents/day for >3 months.
• Pre-existing neurological deficits that may interfere with pain assessment.
• Hypersensitivity to any component of multimodal analgesia or local anesthetics (e.g., bupivacaine, ropivacaine).
• Acute systemic/local infection (e.g., surgical site infection, sepsis).
• Metastatic spinal malignancies (confirmed by imaging/histopathology).
• Pregnancy or lactation.
• Patient refusal after detailed protocol explanation.
• Other investigator-determined high-risk conditions.