Bupivacaine Versus Liposomal Bupivacaine For Pain Control

Abstract

Local infiltrations and regional blocks have been some of the effective ways employed to manage and control post-operative pain. One of the limitations of administration of local anesthesia drugs in post-operative conditions is its inability to act for a longer period of time. Multi-vesicular liposomes made up of bupivacaine have been progressively used for their increased duration of action. Compared to bupivacaine HCL, local infiltration of liposomal bupivacaine have shown to have a significantly increase the duration and delay in peak plasma concentration. In this article, we attempt to compare liposomal bupivacaine and bupivacaine based on available clinical literatures. Liposomal bupivacaine has been demonstrated to have promising implications in post- operative pain control resulting in increased patient satisfaction; reduced hospital admission and opioid induced adverse events. Clinical studies have identified liposomal bupivacaine to be effective in delivering increased post-operative pain control. The purpose of this review is to give a comprehensive comparison between bupivacaine liposomal and conventional bupivacaine based on reported clinical trials.

Liposomal Bupivacaine–Based Erector Spinae Block for Cardiac Surgery

“…Compared with regular bupivacaine, local infiltration of liposomal bupivacaine provides a significant increase in duration and delay of peak plasma concentration. 20 We found that liposomal bupivacaineÀbased ESP block reduced opioid consumption at 4 and 12 hours after extubation. Although the mean values of opioid consumption in the ESPB group were lower than those in the control group at 24, 48, and 72 hours after extubation, there was no statistically significant difference between the two groups.…”

Preoperative Versus Postoperative Use of Transversus Abdominis Plane Block With Nonliposomal Bupivacaine on Postoperative Narcotic Use: A Retrospective Study.

“…Given that TAP block is both feasible and effective for optimizing pain control after colon surgery, it is important to assess whether the additional cost of using liposomal bupivacaine is justi ed. Liposomal bupivacaine, an extended-release version, increases the duration of action of plain bupivacaine [9]. Past industry sponsored studies have shown liposomal bupivacaine to be more effective than plain bupivacaine in controlling pain after colectomy, resulting in fewer narcotics use, faster return of bowel function, and shorter length of stay [16][17][18].…”

“…The TAP block involves injecting bupivacaine into the fascial plane between the internal oblique and transversus abdominis muscles. The duration of action for nonliposomal bupivacaine ranges from 2 to 10 hours with peak effect noted around 30 to 45 minutes [9]. Although liposomal bupivacaine signi cantly increases the duration of action, it also adds extra cost.…”

The role of port site local anesthetic injection in laparoendoscopic single site surgery: a prospective randomized study

“…The patients included in this study had no history of bupivacaine allergy, and no drop out was noted owing to bupivacaine complications. Compared to bupivacaine hydrochloride, liposomal bupivacaine composed of multi-vesicular liposomes has yielded increased plasma concentrations over a longer period [23][24][25]. Further studies exploring various postoperative pain modulators, such as liposomal bupivacaine, might shed new light on postoperative pain management in LESS.…”