Liposome injectableLiposomal bupivacaineSuspension of multivesicular liposomesInfiltrationStandard bupivacaineLiposomesAnalgesicSystemicOpioidPostoperativeRopivacaine2020Peripheral nervePostsurgical analgesiaHemorrhoidectomyReactionsLocalEfficacyAnestheticsSignificantlyPainSurgeryHoursSafetyPatientsResultsStudyEffectStudiesBrandMedicalBlockBreast
Liposome injectable4
- EXPAREL (bupivacaine liposome injectable suspension) is a sterile suspension of multivesicular liposomes using proprietary DepoFoam formulation technology to release bupivacaine over several days. (hindawi.com)
- Exparel (Bupivacaine Liposome Injectable Suspension), USP. (apsf.org)
- A lot changed in 2011 with the US Food and Drug Administration approval of a novel formulation of bupivacaine, called EXPAREL® (bupivacaine liposome injectable suspension). (lplasticsurgery.com)
- The ASCRS/SAGES guidelines state that local anesthetics, such as EXPAREL ® (bupivacaine liposome injectable suspension), that are administered via wound infiltration or transverse abdominis plane (TAP) block may effectively manage pain associated with both open and laparoscopic colorectal surgery. (hcplive.com)
Liposomal bupivacaine12
- What data are available comparing liposomal bupivacaine to other agents? (uic.edu)
- Liposomal bupivacaine may theoretically prolong the duration of action of bupivacaine because the slow release of bupivacaine from the liposome has been shown to maintain systemic plasma concentrations over 96 hours. (uic.edu)
- The table below summarizes the currently published comparative trials of liposomal bupivacaine and does not include placebo-controlled trials. (uic.edu)
- Most trials compared liposomal bupivacaine to bupivacaine hydrochloride, patient-controlled analgesia, or ropivacaine. (uic.edu)
- Trials of liposomal bupivacaine in bunionectomy are placebo-controlled, and therefore, are not discussed in this review. (uic.edu)
- Comparative liposomal bupivacaine studies. (uic.edu)
- The mean cumulative pain score was not significantly different in the liposomal bupivacaine group compared with the bupivacaine HCl group (441.5 vs. 468.2, p=0.3999). (uic.edu)
- NRS-A pain scores at 8 and 12 h were significantly lower with liposomal bupivacaine than bupivacaine HCl. (uic.edu)
- Total amount of opioid consumed was significantly lower at 24 and 48 h with liposomal bupivacaine but not at other time points. (uic.edu)
- Mean opioid use for patients who received liposomal bupivacaine (38 mg) was significantly less compared with the PCA group (68 mg), p=0.004. (uic.edu)
- Of the secondary outcomes, the time to first opioid use was statistically significantly longer with liposomal bupivacaine compared to PCA (1.1 h vs. 0.7 h, p=0.035). (uic.edu)
- Local infiltration analgesia with liposomal bupivacaine improves pain scores and reduces opioid use after total knee arthroplasty: results of a randomized controlled trial. (squintmetrics.com)
Suspension of multivesicular liposomes1
- In addition, Exparel™ a new white aqueous suspension of multivesicular liposomes containing bupivacaine may look similar to propofol (Figure 3) also carries no similar recommendation. (apsf.org)
Infiltration6
- EXPAREL, the proposed proprietary name, was designed to provide prolonged analgesia for 72 hours after wound infiltration in patients [ 8 ]. (hindawi.com)
- Bupivacaine is indicated for local infiltration, peripheral nerve block, sympathetic nerve block, and epidural and caudal blocks. (wikipedia.org)
- Liposomal formulations of bupivacaine (brand name EXPAREL) have not shown clinical benefit compared to plain bupivacaine when used in traditional perineural injections, although some industry-funded studies have suggested benefits when used in local infiltration. (wikipedia.org)
- EXPAREL can provide up to 72 hours of local analgesia and reduced opioid requirements via infiltration at the surgical site. (lplasticsurgery.com)
- 3 Of the currently available local anesthetics, ropivacaine and bupivacaine are long-acting agents that are used for local infiltration. (uic.edu)
- In October 2011, liposomal formulation of bupivacaine (Exparel) was approved by the Food and Drug Administration (FDA) for local infiltration of the surgical site for postsurgical anesthesia with dose recommendations only for two procedures, bunionectomy and hemorrhoidectomy. (uic.edu)
Standard bupivacaine3
- Unlike standard bupivacaine, which produces a 6- to 8-hour analgesic effect, the bupivacaine in EXPAREL is encased in liposomes which break down over time to extend the release of the active drug over a 3-day period. (lplasticsurgery.com)
- For starters, the liposomal composition makes EXPAREL more viscous than standard bupivacaine, so once placed, EXPAREL remains local and does not disperse. (lplasticsurgery.com)
- Primary end point: EXPAREL reduced opioid consumption by 52%, compared with standard bupivacaine, over 72 hours and maintained a significant opioid-minimizing effect over 2 weeks. (squintmetrics.com)
Liposomes1
- Although different liposomal formulations have been administered to humans without toxicity [ 9 ], the in vivo tolerability of liposomes continues to be investigated. (hindawi.com)
Analgesic2
- Bupivacaine is a local anesthetic/analgesic widely used in the perioperative and postsurgical settings. (hindawi.com)
- EXPAREL, the only single-dose, long-acting analgesic that offers a nonopioid option for postsurgical pain control, can play an important role in a multimodal approach. (hcplive.com)
Systemic4
- From a systemic standpoint, high doses of bupivacaine may be associated with a wide range of systemic complications, such as central nervous and cardiovascular effects [ 6 ]. (hindawi.com)
- A formulation of bupivacaine that provides prolonged release of the active ingredient after a single administration would simplify pain management in the postoperative period and eliminate the undesired peak plasma concentrations as a result of excessively high concentrations and reduce the risk of local and systemic reactions [ 7 ]. (hindawi.com)
- Our goal was to evaluate the potential local and systemic toxicity of EXPAREL after a bolus injection into the brachial plexus (i.e., a large, complex bundle of nerves in the shoulder). (hindawi.com)
- Clinically significant adverse events result from systemic absorption of bupivacaine and primarily involve the central nervous and cardiovascular systems. (wikipedia.org)
Opioid3
- During the past 2 years, I have used EXPAREL in more than 300 cases, including hand and leg surgery, breast surgery, and facelifts, and observed consistent results in terms of pain reduction, opioid reduction, and satisfaction. (lplasticsurgery.com)
- By controlling pain during the critical few days after surgery without requiring invasive ports, and eliminating high opioid requirements, EXPAREL allows reconstructive surgery patients to focus on the vitally important psychological and practical aspects of healing from a life-changing procedure. (lplasticsurgery.com)
- 6 This formulation is intended to provide analgesia through the postoperative period to reduce the need for opioids and, thereby, minimize opioid-related adverse effects. (uic.edu)
Postoperative2
- Bupivacaine solutions have been used for many years by multiple routes for the relief of postoperative pain [ 1 ]. (hindawi.com)
- Based on my experience, EXPAREL promises to redefine our approach to intraoperative and postoperative pain control. (lplasticsurgery.com)
Ropivacaine1
- Long-acting local anesthetics (e.g., bupivacaine, levobupivacaine, and ropivacaine) generally provide analgesia of similar duration for 24 hours or less (20-23). (edmariano.com)
20201
- An implantable formulation of bupivacaine (Xaracoll) was approved for medical use in the United States in August 2020. (wikipedia.org)
Peripheral nerve2
- A sustained-release DepoFoam injection formulation of bupivacaine (EXPAREL, 15 mg/mL) is currently being investigated for postsurgical analgesia via peripheral nerve block (PNB). (hindawi.com)
- Specifically, the study was designed to assess whether EXPAREL did not produce nerve damage in the setting of peripheral nerve block by comparison with unencapsulated bupivacaine or saline control. (hindawi.com)
Postsurgical analgesia3
- The fixed-dose combination of bupivacaine with Type I collagen (brand name Xaracoll) is indicated for acute postsurgical analgesia (pain relief) for up to 24 hours in adults following open inguinal hernia repair. (wikipedia.org)
- Results from a phase 3, multicenter, controlled trial that compared the postsurgical analgesia efficacy, safety, and pharmacokinetics of EXPAREL 133 mg (10 mL) and placebo in patients undergoing total shoulder arthroplasty or rotator cuff repair. (squintmetrics.com)
- Bupivacaine extended release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. (squintmetrics.com)
Hemorrhoidectomy1
- Results from a phase 3, multicenter, randomized double-blind, placebo-controlled trial that evaluated the efficacy of 266 mg (20 mL) of EXPAREL in 186 patients undergoing 2- or 3-column excisional hemorrhoidectomy. (squintmetrics.com)
Reactions1
- Bupivacaine is contraindicated in patients with known hypersensitivity reactions to bupivacaine or amino-amide anesthetics. (wikipedia.org)
Local1
- Compared to other local anaesthetics, bupivacaine is markedly cardiotoxic. (wikipedia.org)
Efficacy1
- Results from a phase 4, double-blind, randomized, controlled trial that compared the efficacy and safety of EXPAREL 266 mg (20 mL) (n=70) and bupivacaine HCl (n=69) in a TKA study. (squintmetrics.com)
Anesthetics1
- However, EXPAREL ® behaves differently from traditional anesthetics, including bupivacaine HCl, in a few important ways. (lplasticsurgery.com)
Significantly1
- Results from a prospective, 13-site, multicenter, randomized clinical trial, EXPAREL significantly improved postsurgical recovery when used in a TAP block after C-section. (squintmetrics.com)
Pain3
- Patients treated with EXPAREL, half of whom underwent breast reconstruction while the other half underwent aesthetic procedures, reported an average pain score of 3 (using a NRS scale of 1 to 10), compared to 7 for patients who received the standard pain regimen. (lplasticsurgery.com)
- In addition, patients who received EXPAREL reported being "highly satisfied" with their pain relief. (lplasticsurgery.com)
- The CHMP adopted a positive opinion for Exparel (bupivacaine), for the treatment of post-operative pain. (europeanpharmaceuticalreview.com)
Surgery1
- However, after a few initial cases, it was clear that EXPAREL could greatly enhance the recovery experience of all my patients, especially those undergoing breast cancer surgery and reconstruction. (lplasticsurgery.com)
Hours1
- Bupivacaine (Posimir) is indicated in adults for administration into the subacromial space under direct arthroscopic visualization to produce post-surgical analgesia for up to 72 hours following arthroscopic subacromial decompression. (wikipedia.org)
Safety1
- This study will evaluate the safety and effectiveness of a new formulation of triamcinolone acetonide for the treatment of retinal blood vessel disorders. (drugpatentwatch.com)
Patients1
- Since we added EXPAREL to our pharmacy, I have almost entirely eliminated the use of PCAs, and patients report being more comfortable, able to ambulate sooner, and highly satisfied with their quality of care. (lplasticsurgery.com)
Results1
- The results indicate that EXPAREL was well tolerated in these models and did not produce nerve damage after PNB in rabbits and dogs. (hindawi.com)
Study1
- This study will use a formulation that does not contain these potentially harmful preservatives. (drugpatentwatch.com)
Effect1
- The only EXPAREL-related effect seen was minimal to mild granulomatous inflammation of adipose tissue around nerve roots (8 of 24 rabbits and 7 of 24 dogs) in the brachial plexus sites. (hindawi.com)
Studies1
- Single-dose toxicology studies of EXPAREL (9, 18, and 30 mg/kg), bupivacaine solution (Bsol, 9 mg/kg), and saline injected around the brachial plexus nerve bundle were performed in rabbits and dogs. (hindawi.com)
Brand1
- Bupivacaine, marketed under the brand name Marcaine among others, is a medication used to decrease feeling in a specific area. (wikipedia.org)
Medical1
- Brachial plexus blockade may require dispersion of a relatively large volume of bupivacaine in solution to accomplish blockade of the entire Inhibitors,research,lifescience,medical plexus. (inhibitorlibraries.com)
Block2
- After performing the block procedure, peripheral nerves may be damaged from prolonged contact with concentrated formulations [ 4 , 5 ]. (hindawi.com)
- The 0.75% (most concentrated) formulation is used in retrobulbar block. (wikipedia.org)
Breast1
- Bupivacaine is excreted in breast milk. (wikipedia.org)