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Free academic discourse and the law: the case of liposomal bupivacaine
  1. Jashvant Poeran1,
  2. Genewoo Hong2 and
  3. Stavros G Memtsoudis2
  1. 1Institute for Healthcare Delivery Science, Departments of Orthopaedics / Population Health Science & Policy / Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  2. 2Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, New York, USA
  1. Correspondence to Dr Stavros G Memtsoudis, Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY 10021, USA; memtsoudiss{at}


Liposomal bupivacaine has been the topic of intense academic debate over the past years culminating in an industry-initiated libel lawsuit against the American Society of Anesthesiologists and various other defendants. In this Daring Discourse, we first aim to provide a general overview of main themes in the ongoing controversy: (1) between-study heterogeneity, (2) the high number of negative high-quality reviews and meta-analyses, (3) publication bias in the context of an active role of industry and (4) difference between statistical and clinical significance. We then discuss the contents of the lawsuit, its potential implications and what the recent resolution of this lawsuit means for the future of research and the academic discourse on liposomal bupivacaine.

  • Pain Management
  • analgesia

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  • Twitter @jashvant_p, @sgmemtsoudis

  • Contributors All authors contributed equally to this paper, conceptually, during initial drafting and revisions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer SGM is the owner of SGM Consulting, LLC and partner in Parvizi Surgical Innovations, LLC. SGM is a patent holder for a multicatheter infusion system. He has consulted for Teikoku Pharma Inc.

  • Provenance and peer review Not commissioned; internally peer reviewed.