From the Research
The maximum dose of Exparel (liposomal bupivacaine) is 266 mg (20 mL) for adults, and this dose should not be exceeded within a 72-hour period. For specific procedures, dosing may vary: 106 mg (8 mL) for bunionectomy, 266 mg (20 mL) for hemorrhoidectomy, and up to 266 mg for nerve blocks or field blocks. For pediatric patients aged 6 years and older, the maximum dose is 4 mg/kg, not to exceed 266 mg 1. Exparel works by slowly releasing bupivacaine from liposomal particles, providing prolonged analgesia for up to 72 hours while minimizing systemic absorption and toxicity risks. It's essential to follow proper dilution guidelines when needed and to be aware that exceeding recommended doses can lead to serious adverse effects, including cardiac arrhythmias, seizures, and respiratory depression.
Some key points to consider when using Exparel include:
- The importance of not exceeding the maximum recommended dose within the specified time frame to minimize the risk of adverse effects.
- The variation in dosing for different procedures, which should be carefully considered to ensure the most effective and safe use of Exparel.
- The need for careful patient selection, particularly in pediatric patients, to ensure that the dose does not exceed the maximum recommended amount.
- The potential for Exparel to provide prolonged analgesia, which can be beneficial for patients undergoing surgical procedures, but also requires careful monitoring for potential adverse effects.
Overall, the use of Exparel should be guided by the most recent and highest-quality evidence, and clinicians should carefully consider the potential benefits and risks of using this medication in their patients 2, 3, 1.