The role of liposomal bupivacaine in thoracic surgery

For advocates of regional analgesia, the appeal of a local anesthetic formulation with a duration of action of several days is clear. Liposomal bupivacaine (LB), now with FDA approval for local infiltration and interscalene nerve block—but not neuraxial use though it has been used there (1), provides multiple days of local anesthetic availability though at a lower tissue concentration than standard bupivacaine preparations (bupivacaine hydrochloride; BH).