• Amit Prabhakar, Ceressa T Ward, Matthew Watson, Jay Sanford, Babar Fiza, Vanessa Moll, Rachel J Kaye, Morgan HallOODepartment of Anesthesiology, Louisiana State University School of Medicine, Room 656, 1542 Tulane Ave, New Orleans, LA, 70112, USA. Electronic address: ohall2@lsuhsc.edu., Elyse M Cornett, Richard D Urman, and Alan David Kaye.
• Department of Anesthesiology, Division of Critical Care, Emory University School of Medicine, 550 Peachtree Street, Atlanta, GA, 30308, USA. Electronic address: amit.prabhakar@emory.edu.
• Best Pract Res Clin Anaesthesiol. 2019 Dec 1; 33 (4): 425-432.

AbstractNovel 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.Published by Elsevier Ltd.

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