Real-World Data on Liposomal Bupivacaine and Inpatient Hospital Costs After Colorectal Surgery

Anh Thu Tran, Elsie Rizk, Eric M. Haas, George Naufal, Lixian Zhong, Joshua T. Swan

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: This study compared costs of care among colorectal surgery patients who received liposomal bupivacaine versus those who did not (control) from a health institution perspective. Material and methods: This pharmacoeconomic evaluation was conducted among adults undergoing open or minimally invasive colorectal resection at an academic medical center from May 2016 to February 2018. Healthcare resource utilization was derived from the electronic health record. Total cost of care (2018 USD) was analyzed using a generalized linear model adjusted for American Society of Anesthesiologists score, enhanced recovery after surgery management, open surgery, opioid use before surgery, height, cancer, and age. The primary analysis used public costs. A sensitivity analysis used internal costs from the hospital to maximize internal validity. Results: Of 486 included patients, 286 (59%) received liposomal bupivacaine. Total cost of care using public costs included perioperative local anesthetics (mean ± standard deviation [SD]: $392 ± 74 liposomal bupivacaine versus $8 ± 13 control), analgesics within 48 h after surgery (mean ± SD: $132 ± 99 liposomal bupivacaine versus $117 ± 127 control), postoperative ileus management (mean ± SD: $5 ± 51 liposomal bupivacaine versus $65 ± 284 control), and hospital length of stay (mean ± SD: $4459 ± 3576 liposomal bupivacaine versus $7769 ± 7082 control). Liposomal bupivacaine was associated with an adjusted absolute difference in total cost of care of −$1435 (95% confidence interval −$2401 to −$470; P = 0.004) using public costs and −$1345 (95% confidence interval −$2215 to −$476; P = 0.002) using internal costs. Conclusions: Use of liposomal bupivacaine in colorectal surgery was associated with a significant reduction in total cost of care that was predominately driven by reduced costs for hospital stay and postoperative ileus management despite higher medication costs.

Original languageEnglish (US)
Pages (from-to)175-183
Number of pages9
JournalJournal of Surgical Research
StatePublished - Apr 2022


  • Colorectal surgery
  • Hospital cost
  • Liposomal bupivacaine
  • Local anesthetic
  • Opioid
  • Pain management
  • Hospital Costs
  • Anesthetics, Local/therapeutic use
  • Humans
  • Inpatients
  • Analgesics, Opioid/therapeutic use
  • Colorectal Surgery
  • Bupivacaine/therapeutic use
  • Ileus
  • Adult
  • Retrospective Studies
  • Liposomes
  • Pain, Postoperative/drug therapy

ASJC Scopus subject areas

  • Surgery


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