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Liposomal bupivacaine (Exparel) is an extended-release formulation of the local anesthetic bupivacaine, utilizing the DepoFoam multivesicular liposomal delivery system. Developed by Pacira BioSciences, it is designed to provide prolonged postsurgical analgesia for up to 72 hours by slowly releasing bupivacaine into the surgical site or near nerves. Bupivacaine acts by binding to and blocking voltage-gated sodium channels on the internal surface of nerve cell membranes, preventing the generation and conduction of nerve impulses. This mechanism effectively provides local anesthesia and reduces the need for systemic opioids. It is indicated for single-dose infiltration in adults to produce postsurgical local analgesia and as an interscalene brachial plexus nerve block for postsurgical regional analgesia.
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