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Exparel is a liposomal formulation of the amide-type local anesthetic bupivacaine, designed for extended-release postsurgical analgesia. Developed by Pacira BioSciences using the proprietary DepoFoam technology, it consists of microscopic, multivesicular liposomes that encapsulate bupivacaine and release it slowly over time. The mechanism of action involves the reversible blockade of voltage-gated sodium channels on nerve membranes, which prevents the conduction of action potentials and inhibits the transmission of pain signals from the surgical site. It is FDA-approved for local infiltration in various surgical procedures and for use as an interscalene brachial plexus nerve block. The specific trial led by Alexandra Black (NCT04141371) investigates its efficacy compared to standard bupivacaine HCl in patients undergoing forefoot surgery to reduce postoperative pain and opioid consumption.
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