BACKGROUND: The development of liposomal bupivacaine (LB) as an anesthetic was widely lauded due to the potential benefits this drug claimed to carry. This systematic review and meta-analysis aimed to assess the efficacy of LB versus standard bupivacaine (SB) in improving postoperative outcomes, including pain scores and morphine use. METHODS: PubMed, Cochrane CENTRAL, Web of Science, and MedLine databases were searched until April 2024. All trials evaluating the efficacy of LB versus SB in abdominal surgeries like colorectal procedures, bariatric surgeries, and hemorrhoidectomy were included. Data analysis was conducted in Review Manager employing a random-effects model. RESULTS: Eight clinical trials with 810 patients were included. No statistically or clinically significant result was obtained on using LB over SB in reducing postoperative pain score on postoperative day 0 (POD0) (mean difference (MD) = -0.19, [95% confidence interval (CI): -0.91, 0.53]
p = 0.60), POD1 (MD = -0.11 [95% CI: -1.12, 0.91]
p = 0.84), POD2 (MD = -0.18 [95% CI: -0.57, 0.22]
p = 0.22), and POD3 (MD = 0.01 [95% CI: -0.55, 0.22]
p = 0.57). Additionally, there was no reduction in morphine use in PODs 0-3, time to ambulation, hours to postoperative flatus, or length of hospital stay between the groups. CONCLUSION: Our findings showed that LB is not superior to SB in the surgical plane for individuals undergoing abdominal procedures.