title: Liposomal bupivacaine and clinical outcomes.
abstract: In the multimodal approach to the management of postoperative pain, local infiltration and regional blocks have been increasingly utilized for pain control. One of the limitations of local anesthetics in the postoperative setting is its relatively short duration of action. Multivesicular liposomes containing bupivacaine have been increasingly utilized for their increased duration of action. Compared with bupivacaine HCl, local infiltration of liposomal bupivacaine has shown to have an increase in duration of action and causes delay in peak plasma concentration. In this article, we attempt to review the clinical literature surrounding liposomal bupivacaine and its evolving role in perioperative analgesia. This new bupivacaine formation may have promising implications in postoperative pain control, resulting in increased patient satisfaction and a decrease in both hospital stay and opioid-induced adverse events (AEs). Although more studies are needed, the preliminary clinical trials suggest that liposomal bupivacaine has predictable pharmacokinetics, a similar side effect profile compared with bupivacaine HCl, and is effective in providing increased postoperative pain control.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: yctong@partners.org.
authors.forename: Yi Cai Isaac
authors.initials: YC
authors.lastname: Tong
authors.affiliation: Department of Anesthesiology, LSU School of Medicine, New Orleans, LA, USA; Department of Pharmacology, LSU School of Medicine, New Orleans, LA, USA. Electronic address: alankaye44@hotmail.com.
authors.forename: Alan David
authors.initials: AD
authors.lastname: Kaye
authors.affiliation: Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: rurman@partners.org.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D015195:Drug Design; D006801:Humans; D007902:Length of Stay; D008081:Liposomes; D009407:Nerve Block / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D019990:Perioperative Care / Q000379:methods
chemical_list: D000779:Anesthetics, Local; D008081:Liposomes; D002045:Bupivacaine
keywords: adult anesthetics; local/administration and dosage anesthetics; local/adverse effects anesthetics; local/therapeutic use bupivacaine/administration and dosage bupivacaine/adverse effects bupivacaine/therapeutic use