Some studies have showed statistically significant positive results when evaluating Liposomal Bupivacaine for nerve blocks (https://journals.lww.com/rapm/Abstract/2017/05000/Addition_of_Liposome_Bupivacaine_to_Bupivacaine.10.aspx) while other clinicians have cautioned about the results of fixed long-acting nerve blocks that cannot be titrated or turned off (https://academic.oup.com/painmedicine/article/16/1/13/2460237). EXPAREL, a liposomal formulation of Bupivacaine, is applying for a Supplemental New Drug Application (sNDA) for the nerve block indication that will be presented to the FDA this week (https://www.fda.gov/AdvisoryCommittees/Calendar/ucm592118.htm). Is this the future of regional anesthesia? How will this liposomal approach ultimately compare to standard single injection nerve blocks with or without dexamethasone? Will nerve blocks with liposomal bupivacaine result in similar analgesia, narcotic consumption, and motor sparing when compared to continuous perineural catheters, the current gold standard for long-lasting perineural blockade? Please share your thoughts on the topic of liposomal bupivacaine for nerve blocks.
I don’t have our block duration data collected yet but the opioid consumption has been very low followed for five days. We are 1st opening the space injecting 10ml 0.5% plain bupivacaine between middle scalene and C5/6 then 10ml of Exparel.