Exparel/Peripheral Catheter Use in the Ambulatory Setting and Use of Peripheral Catheters Postoperatively in the Home Setting.

PURPOSE OF REVIEW: With the increasing number of ambulatory surgeries being performed, regional anesthesia has become an increasingly popular anesthetic modality, and many choices exist to provide efficient, effective quality perioperative analgesia. In this paper, we will review the various regional anesthesia options in addition to the advantages and disadvantages of each. Lastly, we will discuss liposomal bupivicaine, a long acting local anesthetic, and its future role in the anesthesiologist's armamentarium. The aim of the publication is to provide a general overview of regional anesthesia as well as to discuss the advantages and disadvantages of this modality. Additionally, we sought to review the basics of liposomal bupivicaine as well as the relevant literature.

RECENT FINDINGS: The results regarding liposomal bupivicaine are mixed and mainly focuses on local infiltration and intra-articular injections. There are no known studies specifically comparing liposomal bupivicaine to bupivicaine hydrochloride in ultrasound-guided nerve blocks. There is some encouraging data regarding liposomal bupivicaine, but further studies are needed before it is adopted as a mainstay of treatment. In addition to efficacy, additional investigations are needed to evaluate cost as this could be a major impediment to its implementation.