Liposomal bupivacaine: a review of a new bupivacaine formulation

Figures & data

Figure 1 Scanning electron microscope image of DepoFoam^® containing bupivacaine.

Image supplied courtesy of Pacira Pharmaceuticals, Inc, 5 Sylvan Way, Parsippany, NJ 07054.

Figure 2 Cross-sectional diagram of DepoFoam containing bupivacaine.

Image supplied courtesy of Pacira Pharmaceuticals, Inc, 5 Sylvan Way, Parsippany, NJ 07054.

Table 1 Studies comparing the efficacy of MVL bupivacaine versus placebo or bupivacaine HCl

Author	Type of study	Comparison	Surgery	Primary outcome	Results
Gorfine et al^Citation27	RCT	300 mg DepoFoam bupivacaine compared with placebo	Hemorrhoidectomy	AUC0–72 of NRS pain intensity scores	Least square mean (SE) AUC0–72 141.8 (10.7) in the DepoFoam bupivacaine (n = 94) group compared to 202.5 (10.7) in placebo (n = 93). P < 0.0001.
Golf et al^Citation28	RCT	120 mg DepoFoam bupivacaine compared with placebo	Bunionectomy	AUC0–24 of NRS pain intensity scores	Least square mean (SE) AUC0–24 123.936 (4.4854) in DepoFoam bupivacaine group (n = 93) compared to 146.233 (4.5869) in placebo (n = 92). P < 0.0005. 95% CI of difference between DepoFoam bupivacaine vs placebo −34.799 to −9.794.
Smoot et al^Citation29	RCT	600 mg DepoFoam bupivacaine compared with 200 mg bupivacaine HCl with epinephrine 1:200,000	Submuscular augmentation mammoplasty	AUC0–72 of NRS-A pain intensity scores	Mean (SE) AUC0–72 441.5 (23.6) in DepoFoam bupivacaine group (n = 66) and 468.2 (23.0) in bupivacaine HCl group (n = 70). P = 0.3999.
Bramlett et al^Citation30	RCT	Bupivacaine HCl 150 mg (0.5%) with epinephrine 1:200,000 compared with four doses of DepoFoam bupivacaine (133, 266, 399, and 532 mg)	Total knee arthroplasty	AUC0–96 of NRS-A pain intensity scores	Mean (SD) 20.7 (5.4), 19.5 (5.3), 18.8 (5.3), and 19.1 (4.4) in DepoFoam bupivacaine 133 mg, 266 mg, 399 mg, and 532 mg groups (n = 25, 24, 26, and 21, respectively) and 20.4 (3.9) in the bupivacaine HCl group (n = 30). P value >0.05 in each DepoFoam bupivacaine group compared to bupivacaine HCl group.

Abbreviations: AUC, area under the curve; MVL, multivesicular liposomes; NRS, numerical rating score; NOS, not otherwise specified; NRS-A, numerical rating score with activity; RCT, randomized clinical trial; SD, standard deviation; SE, standared error.

GorfineSROnelEPatouGKrivokapicZVBupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trialDis Colon Rectum201154121552155922067185

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GolfMDanielsSEOnelEA phase 3, randomized, placebo-controlled trial of DepoFoam® bupivacaine (extended-release bupivacaine local analgesic) in bunionectomyAdv Ther201128977678821842428

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SmootJDBergeseSDOnelEWilliamsHTHeddenWThe efficacy and safety of DepoFoam bupivacaine in patients undergoing bilateral, cosmetic, submuscular augmentation mammoplasty: a randomized, double-blind, active-control studyAesthet Surg J2012321697622179931

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BramlettKOnelEViscusiERJonesKA randomized, double-blind, dose-ranging study comparing wound infiltration of DepoFoam bupivacaine, an extended-release liposomal bupivacaine, to bupivacaine HCl for postsurgical analgesia in total knee arthroplastyKneeIn press1272012

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