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Liposomal bupivacaine: a delay rather than elimination of rebound pain in mouse postoperative model

Hao Wu1, Jiayu Jin2, Di Zhou2

  • 1Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, China.

BMC Anesthesiology
|November 27, 2025
PubMed
Abstract

Insights

Liposomal bupivacaine (LB) delays, but does not prevent, rebound pain after nerve blocks. This study found LB extended analgesia but caused delayed pain and increased nerve inflammation in mice.

Area of Science:

  • Anesthesiology
  • Pain Management
  • Pharmacology

Background:

  • Prolonged analgesia with liposomal bupivacaine (LB) is established, but its effect on rebound pain remains unclear.
  • This study investigates if LB prevents or merely delays rebound pain following peripheral nerve blockade.

Purpose of the Study:

  • To determine the effect of LB on rebound pain in a mouse model.
  • To assess if nerve block resolution with LB results in pain exceeding unblocked controls.

Main Methods:

  • Nerve stimulator-guided vs. landmark-based sciatic and femoral nerve blockade success rates were compared using methylene blue staining.
  • Rebound pain after LB administration was assessed using von Frey and Hargreaves tests.
  • Histological analyses examined perineural inflammation and Wallerian degeneration.

Main Results:

  • Nerve stimulator guidance demonstrated high block success rates (93.3% sciatic, 73.3% femoral).
  • LB extended thermal (24h) and mechanical (36h) analgesia.
  • Transient thermal rebound pain occurred at 48h; no mechanical rebound was observed. Increased Wallerian degeneration and nerve inflammation were noted in the LB group.

Conclusions:

  • Liposomal bupivacaine delays the onset of rebound pain rather than preventing it.
  • LB administration in a mouse model resulted in delayed pain and increased nerve inflammation.
Keywords:
Acute postoperative painLiposomal bupivacaineMiceRebound painRegional anesthesia

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