Liposome bupivacaine in peripheral nerve blocks and epidural injections to manage postoperative pain

Ilfeld, Brian M

doi:10.1517/14656566.2013.844791

Cited by 39 publications

(19 citation statements)

References 41 publications

(43 reference statements)

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“…However, despite the encouraging pharmacodynamic and pharmacokinetic data in both animals and humans, little is understood about the factors that control drug release from the liposomes in this preparation. Only a few clinical studies have reported the use of perineural or neuraxial liposomal local anesthetic administration, [13][14][15] and adequate preclinical studies demonstrating the lack of neurotoxicity have not yet been reported; consequently liposomal local anesthetics do not meet consensus criteria for the use of investigational neuraxial drugs. 16 Accordingly, the clinical utility of liposomal local anesthetics has currently been limited to wound infiltration in peripheral surgery; bunionectomy, 17 hemorrhoidectomy, 18 breast augmentation, 19 and knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Proliposomal Ropivacaine Oil: Pharmacokinetic and Pharmacodynamic Data After Subcutaneous Administration in Volunteers

Ginosar

Haroutounian

Kagan

et al. 2016

Anesthesia &Amp; Analgesia

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Section: Discussionmentioning

confidence: 99%

Proliposomal Ropivacaine Oil: Pharmacokinetic and Pharmacodynamic Data After Subcutaneous Administration in Volunteers

Ginosar

Haroutounian

Kagan

et al. 2016

Anesthesia &Amp; Analgesia

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“…Considering the lack of RCT-demonstrated benefits of liposome bupivacaine versus bupivacaine HCl combined with the 100-fold increase in cost of the former over the latter, it appears that additional data demonstrating analgesic or other benefits is warranted prior to widespread adoption of the new formulation. It is notable-and should give pause to practitioners considering replacing bupivacaine HCl with liposome bupivacaine-that of 12 RCTs comparing these two bupivacaine formulations for various procedures including breast surgery, only one involving hemorrhoidectomy demonstrated an analgesic improvement [72][73][74][75][76][77][78].…”

Section: Liposome Bupivacainementioning

confidence: 99%

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

Cheng

2016

Pain Med

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Objective. To review the published evidence regarding perioperative analgesic techniques for breast cancer-related surgery.Design. Topical review.Methods. Randomized, controlled trials (RCTs) were selected for inclusion in the review. Also included were large prospective series providing estimates of potential risks and technical reports and small case series demonstrating a new technique or approaches of interest to clinicians.Results. A total of 514 abstracts were reviewed, with 284 studies meeting criteria for full review. The evidence regarding preemptive ketamine, scheduled opioids, perioperative non-steroidal anti-inflammatory drugs (NSAIDs), and intravenous lidocaine is mixed and deserves further investigation. There is strong evidence that both pregabalin and gabapentin provide analgesic benefits following breast surgery. There is minimal and conflicting data from highquality randomized, controlled studies suggesting that directly infiltrating and/or infusing local anesthetic (liposome encapsulated or unencapsulated) into the surgical wound is a reliably effective analgesic. In contrast, there is a plethora of data demonstrating the potent analgesia, opioid sparing, and decreased opioid-related side effects from thoracic epidural infusion and both single-injection and continuous paravertebral nerve blocks (the latter two demonstrating decreased persistent post-surgical pain between 2.5 and 12 months). Techniques with limited-yet promising-data deserving additional investigation include brachial plexus blocks, cervical epidural infusion, interfascial plane blocks, and interpleural blocks.Conclusions. While there are currently multiple promising analgesic techniques for surgical procedures of the breast that deserve further study, the only modalities demonstrated to provide potent, consistent perioperative pain control are thoracic epidural infusion and paravertebral nerve blocks.

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“…Liposomal bupivacaine has been approved by the U.S. Food and Drug Administration for administration into the surgical site, with proven safety in both animal and human studies. [5] This suspension is created using a lipid-based delivery system that encapsulates the drug in multivesicular liposomal particles that then release the drug over a 72-hour time period. [6] Although, there were several randomized controlled trials (RCTs) comparing liposomal bupivacaine and interscalene nerve block for pain control in TSA; however, the results were controversial.…”

Section: Introductionmentioning

confidence: 99%

Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty

Zeng

Zong

2017

Medicine

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Background:Postoperative pain control after total shoulder arthroplasty (TSA) can be challenging. Liposomal bupivacaine and interscalene nerve block are 2 common pain control protocol for TSA patients. However, whether liposomal bupivacaine was superior than interscalene nerve block was unknown. This meta-analysis aimed to illustrate the efficacy liposomal bupivacaine versus interscalene nerve block for pain control in patients undergoing TSA.Methods:In May 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database. Data on patients prepared for TSA in studies that compared liposomal bupivacaine versus interscalene nerve block were retrieved. The endpoints were the visual analogue scale (VAS) at 4 hours, 8 hours, 12 hours, 24 hours, and 2 weeks, total morphine consumption at 24 hours, and the length of hospital stay. Software of Stata 12.0 was used for pooling the final outcomes.Results:Five clinical studies with 573 patients (liposomal bupivacaine group = 239, interscalene nerve block group = 334) were ultimately included in the meta-analysis. There was no significant difference between the VAS at 4 hours, 8 hours, and 2 weeks between liposomal bupivacaine group and interscalene nerve block group (P > .05). Compared with interscalene nerve block group, liposomal bupivacaine was associated with a reduction of VAS score at 12 hours, 24 hours by appropriately 3.31 points and 6.42 points respectively on a 100-point VAS. Furthermore, liposomal bupivacaine was associated with a significantly reduction of the length of hospital stay by appropriately by 0.16 days compared with interscalene nerve block group.Conclusion:Current meta-analysis indicates that compared with interscalene nerve block, liposomal bupivacaine had comparative effectiveness on reducing both pain scores and the length of hospital stay. However, studies with more patients and better-designed methods are needed to establish the optimal regimen and the safety of liposomal bupivacaine in TSA patients.

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Liposome bupivacaine in peripheral nerve blocks and epidural injections to manage postoperative pain

Cited by 39 publications

References 41 publications

Proliposomal Ropivacaine Oil: Pharmacokinetic and Pharmacodynamic Data After Subcutaneous Administration in Volunteers

Proliposomal Ropivacaine Oil: Pharmacokinetic and Pharmacodynamic Data After Subcutaneous Administration in Volunteers

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty

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