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bupivacaine + liposomal bupivacaine is a local anesthetic combination used in the ABC block (Anterior Blocks for Cardiac surgery) protocol. Developed and studied at Duke University, this regional anesthesia technique involves ultrasound-guided parasternal intercostal (or transversus thoracis plane) and rectus sheath blocks for patients undergoing median sternotomy. The mixture combines standard bupivacaine hydrochloride for rapid onset of action with liposomal bupivacaine (Exparel) for sustained release, aiming to provide prolonged postoperative analgesia (up to 72 hours) and reduce systemic opioid requirements in cardiac surgery recovery.
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