A clinical review of the three articles around LB in February 2021 issue of Anesthesiology
‘Perineural Liposomal Bupivacaine Is Not Superior to Nonliposomal Bupivacaine for Peripheral Nerve Block Analgesia’ Meta-analysis by Hussain, et al.
evaluating the difference in 24 hr to 72 hr rest pain severity scores for liposomal and nonliposomal bupivacaine
Outcome difference in area under the curve pain rest scores was statistically significant but not clinically meaningful
Excluding the industry-sponsored study rendered the difference between the groups nonsignificant.
‘Clinical Effectiveness of Liposomal Bupivacaine Administered by Infiltration or Peripheral Nerve Block to Treat Postoperative Pain: A Narrative Review’ Narrative Review by Ilfeld et al.
involving the clinical administration, by infiltration or peripheral nerve block, of LB to control postoperative pain.
12 Studies with Surgical LB vs. Plain Bupivacaine Nerve Block (PNB)
‘Liposomal Bupivacaine Effective, Cost-effective, or (Just) Costly?’ Editorial by McCann
Dr. McCann
out of Harvard Medical School and Boston Children’s Hospital was the acting chair for the FDA’s Anesthetic and Analgesic Drug Products Advisory Committee February 14 and 15, 2018
Advised on Pacira’s sNDA application for expanded indication for Exparel for nerve blocks.
Calls out lack of clinical superiority of Exparel to generic bupivacaine and their relative costs
CONCLUSION
”Perineural liposomal bupivacaine provided a statistically significant but clinically unimportant improvement in the AUC of postoperative pain scores compared with plain local anesthetic.
”The preponderance of evidence fails to support the routine use of liposomal bupivacaine over standard local anesthetics.
”In this era of medical austerity, when the benefits and costs of expensive drugs are being considered, one would hope that newly approved expensive drugs would at least be an improvement over existing, inexpensive drugs.