Role of liposomal bupivacaine in pain management after total joint arthroplasty

Abstract

The utilization of multimodal pain management following total joint arthroplasty (TJA) has positively affected the quality of postoperative care, reduced surgical pain, and decreased the magnitude of opioid consumption and subsequent dose-related complications. The advent of liposomal bupivacaine is proving to be a highly efficacious and safe method of postoperative pain management with favorable pharmacokinetics that reduces the risk of amide-related toxicity. Additionally, the therapeutic levels of bupivacaine, which are below the toxic range and sustained for 72 hours after injection, are providing an effective mechanism for early hospital discharge and rapid recovery after TJA. This article reviews the rationale behind liposomal bupivacaine, its mechanism of action, pharmacokinetics, indications, and contraindications for use.