morphine + bupivacaine + multi-modal pain regimen

This multimodal analgesic regimen was evaluated by Pacira Pharmaceuticals (now Pacira BioSciences) in the Phase 4 CHOICE clinical trial for the management of postoperative pain following elective Cesarean section. The regimen combines the use of EXPAREL (bupivacaine liposome injectable suspension) administered via transversus abdominis plane (TAP) infiltration with a low dose of intrathecal morphine (Duramorph). EXPAREL utilizes DepoFoam technology to provide extended-release delivery of bupivacaine, which acts as a local anesthetic by blocking voltage-gated sodium channels to inhibit nerve conduction at the surgical site. Morphine serves as a systemic opioid analgesic that activates mu-opioid receptors in the central nervous system to modulate pain perception. This multimodal approach is designed to provide prolonged postsurgical analgesia for up to 72 hours while significantly reducing the total consumption of systemic opioids and their associated side effects.

Brand names

EXPARELDuramorph

Other names

CHOICE study regimenEXPAREL TAP + Duramorph regimen