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Summary  A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether regional liposomal bupivacaine was superior to standard bupivacaine for pain control following minimally invasive thoracic surgery. Altogether 70 papers were found using the reported search, of which 5 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Two of the five available studies showed a significant reduction of early narcotic consumption with the regional analgesia using liposomal bupivacaine, one showed a significantly reduced usage of opioid medication during postoperative hour 24–36 among the patients receiving liposomal bupivacaine, and 2 showed no difference in cumulative opioid consumption between the 2 regional analgesia groups. In addition, there was no associated difference in the pain severity scores or the length of hospitalization.

Is liposomal bupivacaine superior to standard bupivacaine for pain control following minimally invasive thoracic surgery?