Liposomal bupivacaine has been the topic of intense academic debate over the past years culminating in an industry-initiated libel lawsuit against the American Society of Anesthesiologists and various other defendants. In this Daring Discourse, we first aim to provide a general overview of main themes in the ongoing controversy: (1) between-study heterogeneity, (2) the high number of negative high-quality reviews and meta-analyses, (3) publication bias in the context of an active role of industry and (4) difference between statistical and clinical significance. We then discuss the contents of the lawsuit, its potential implications and what the recent resolution of this lawsuit means for the future of research and the academic discourse on liposomal bupivacaine.
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http://dx.doi.org/10.1136/rapm-2023-104547 | DOI Listing |
Eur J Pharm Biopharm
January 2025
National Advanced Medical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai 201203 PR China. Electronic address:
Current analgesics on the market exhibit a short duration of action and induce the production of inflammatory factors in tissues damaged by surgical procedures. Inflammatory factor production can create acidic environments, limiting drug delivery. In this study, we developed a novel injectable formulation comprising bupivacaine multivesicular liposomes of high osmotic pressure (H-MVL) and meloxicam nanocrystals (MLX) in a thermosensitive gel (H-MVL/MLX@GEL) adapted to the microenvironment for long-term postoperative analgesia.
View Article and Find Full Text PDFJ Neurosurg Spine
January 2025
2Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida.
Objective: Awake, endoscopic spinal fusion has been utilized as an ultra-minimally invasive surgery technique to accomplish the goals of spinal fixation, fusion, and disc height restoration. While many techniques exist for this approach, this series represents a single institution's experience with a large cohort and the evolution of this method.
Methods: The medical records of a consecutive series of 400 patients treated over a 10-year period were retrospectively reviewed.
J Clin Med
December 2024
Department of Anesthesiology, Duke University Medical Center, DUMC 3094, Durham, NC 27710, USA.
: In 2021, the Food and Drug Administration approved liposomal bupivacaine injectable suspension for single-dose infiltration in patients ≥ 6 years of age. Liposomal bupivacaine and bupivacaine hydrochloride admixtures may also be administered off-label for pediatric regional anesthesia including peripheral nerve blocks (PNBs). This single-injection, long-acting technique is not well described in pediatrics but may have benefits over traditional continuous catheter-based systems.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA.
Background: Liposomal bupivacaine (LB) is a relatively novel anesthetic agent used in the management of postoperative pain in patients who have undergone shoulder surgery.
Purpose: To explore the literature on LB in the setting of shoulder surgery and assess its efficacy and utility in managing postoperative pain.
Study Design: Systematic review and meta-analysis; Level of evidence, 1.
Cureus
November 2024
Education, Twin Oaks Anesthesia Services, Wesley Chapel, USA.
Open or arthroscopic repair of hamstring tear requires both hard and soft, posterior and proximal thigh analgesia. Regional injections to completely relieve this unique pain are not available to the best of our knowledge. We present a novel, single injection, performed under ultrasound guidance, that utilizes the deep piriformis space.
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