title: New formulations of bupivacaine for the treatment of postoperative pain: liposomal bupivacaine and SABER-Bupivacaine.
abstract: BACKGROUND
  Although generally considered both safe and effective, local anesthetics are often used in conjunction with opioids postoperatively in part because of the limited duration of drug action of local anesthetics. Much interest exists in extending the duration of local anesthetics' effects, which may reduce the requirement for opioid pain medications that are frequently associated with side effects, including nausea and vomiting, pruritus and respiratory depression.
  
  
  METHODS
  This article introduces liposomal bupivacaine and SABER®-Bupivacaine, two new formulations of bupivacaine that increase the duration of analgesia postoperatively through two novel slow-release technologies. The pharmacodynamics, pharmacokinetics, efficacy and safety of both preparations of bupivacaine are reviewed. An electronic database search conducted using the Cochrane Central Register of Controlled Trials and MEDLINE/PubMed with the following search terms: 'bupivacaine,' 'liposomal bupivacaine', 'liposome bupivacaine', 'Exparel', 'SABER-Bupivacaine', 'SABER Bupivacaine', and 'SABER' yielded 90 articles (no language or date of publication restrictions were imposed).
  
  
  CONCLUSIONS
  Clinical trials involving liposomal bupivacaine and SABER-Bupivacaine indicate that both safely prolong analgesia, while decreasing opioid requirements when compared with placebo. However, additional clinical studies are necessary to better determine the efficacy and cost-effectiveness of these long-acting local anesthetic formulations.
authors.affiliation: Duke University Medical Center, Department of Anesthesiology , Durham, NC 27710 , USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Skolnik
authors.forename: Tong J
authors.initials: TJ
authors.lastname: Gan
mesh_terms: D000701:Analgesics, Opioid / Q000493:pharmacokinetics / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002045:Bupivacaine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002626:Chemistry, Pharmaceutical; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002045:Bupivacaine
keywords: SABER-Bupivacaine; bupivacaine; liposomal bupivacaine; local anesthetics; postoperative pain