Liposomal bupivacaine and novel local anesthetic formulations

Amit Prabhakar, Ceressa T. Ward, Matthew Watson, Jay Sanford, Babar Fiza, Vanessa Moll, Rachel J. Kaye, O. Morgan Hall, Elyse M. Cornett, Richard D. Urman, Alan David Kaye

Research output: Contribution to journalReview articlepeer-review

38 Scopus citations

Abstract

Novel preparations allowing for the extended duration of action of local anesthetics have many clinically relevant benefits. With regard to this, the development of liposomal bupivacaine has the potential to significantly impact patient care by improving perioperative pain control. The unique liposomal bilayer that encapsulates bupivacaine allows for a sustained release of local anesthetic for up to 72 h after a single use and can significantly decrease postoperative opioid consumption. SABER-bupivacaine is another depot formulation that helps in sustained release of bupivacaine from an encapsulated bupivacaine in a biodegradable sucrose acetate isobutyrate biolayer. HTX-011 is an investigational extended-release local anesthetic formulation currently undergoing Phase 3 clinical trials. HTX-011 is composed of a bioerodible polymer with bupivacaine and low-dose meloxicam in which the polymer undergoes hydrolysis and allows for sustained release of bupivacaine and meloxicam for 3 days. The present investigation reviews pharmacologic considerations related to the formulation of liposomal bupivacaine, current FDA-approved indications for its use, and future extended-release local anesthetic formulations currently under investigation.

Original languageEnglish (US)
Pages (from-to)425-432
Number of pages8
JournalBest Practice and Research: Clinical Anaesthesiology
Volume33
Issue number4
DOIs
StatePublished - Dec 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019

Keywords

  • bupivacaine
  • liposomes
  • local anesthetic
  • microspheres
  • multimodal analgesia
  • regional anesthesia

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