Treatment of Digital Ischemia with Liposomal Bupivacaine
Objective. This report describes a case in which the off-label use of liposomal bupivacaine (Exparel) in a peripheral nerve block resulted in marked improvement of a patient’s vasoocclusive symptoms. The vasodilating and analgesic properties of liposomal bupivacaine in patients with ischemic symptom...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2014/853243 |
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| author | José Raul Soberón Scott F. Duncan W. Charles Sternbergh |
| author_facet | José Raul Soberón Scott F. Duncan W. Charles Sternbergh |
| author_sort | José Raul Soberón |
| collection | DOAJ |
| description | Objective. This report describes a case in which the off-label use of liposomal bupivacaine (Exparel) in a peripheral nerve block resulted in marked improvement of a patient’s vasoocclusive symptoms. The vasodilating and analgesic properties of liposomal bupivacaine in patients with ischemic symptoms are unknown, but our clinical experience suggests a role in the management of patients suffering from vasoocclusive disease. Case Report. A 45-year-old African American female was admitted to the hospital with severe digital ischemic pain. She was not a candidate for any vascular surgical or procedural interventions. Two continuous supraclavicular nerve blocks were placed with modest clinical improvement. These effects were also short-lived, with the benefits resolving after the discontinuation of the peripheral nerve blocks. She continued to report severe pain and was on multiple anticoagulant medications, so a decision was made to perform an axillary nerve block using liposomal bupivacaine (Exparel) given the compressibility of the site as well as the superficial nature of the target structures. Conclusions. This case report describes the successful off-label usage of liposomal bupivacaine (Exparel) in a patient with digital ischemia. Liposomal bupivacaine (Exparel) is currently FDA approved only for wound infiltration use at this time. |
| format | Article |
| id | doaj-art-15213e76bf574e949bf881f7d44a264c |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-15213e76bf574e949bf881f7d44a264c2025-02-03T01:10:34ZengWileyCase Reports in Anesthesiology2090-63822090-63902014-01-01201410.1155/2014/853243853243Treatment of Digital Ischemia with Liposomal BupivacaineJosé Raul Soberón0Scott F. Duncan1W. Charles Sternbergh2Department of Anesthesiology, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USADepartment of Orthopedic Surgery, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USAVascular and Endovascular Surgery, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USAObjective. This report describes a case in which the off-label use of liposomal bupivacaine (Exparel) in a peripheral nerve block resulted in marked improvement of a patient’s vasoocclusive symptoms. The vasodilating and analgesic properties of liposomal bupivacaine in patients with ischemic symptoms are unknown, but our clinical experience suggests a role in the management of patients suffering from vasoocclusive disease. Case Report. A 45-year-old African American female was admitted to the hospital with severe digital ischemic pain. She was not a candidate for any vascular surgical or procedural interventions. Two continuous supraclavicular nerve blocks were placed with modest clinical improvement. These effects were also short-lived, with the benefits resolving after the discontinuation of the peripheral nerve blocks. She continued to report severe pain and was on multiple anticoagulant medications, so a decision was made to perform an axillary nerve block using liposomal bupivacaine (Exparel) given the compressibility of the site as well as the superficial nature of the target structures. Conclusions. This case report describes the successful off-label usage of liposomal bupivacaine (Exparel) in a patient with digital ischemia. Liposomal bupivacaine (Exparel) is currently FDA approved only for wound infiltration use at this time.http://dx.doi.org/10.1155/2014/853243 |
| spellingShingle | José Raul Soberón Scott F. Duncan W. Charles Sternbergh Treatment of Digital Ischemia with Liposomal Bupivacaine Case Reports in Anesthesiology |
| title | Treatment of Digital Ischemia with Liposomal Bupivacaine |
| title_full | Treatment of Digital Ischemia with Liposomal Bupivacaine |
| title_fullStr | Treatment of Digital Ischemia with Liposomal Bupivacaine |
| title_full_unstemmed | Treatment of Digital Ischemia with Liposomal Bupivacaine |
| title_short | Treatment of Digital Ischemia with Liposomal Bupivacaine |
| title_sort | treatment of digital ischemia with liposomal bupivacaine |
| url | http://dx.doi.org/10.1155/2014/853243 |
| work_keys_str_mv | AT joseraulsoberon treatmentofdigitalischemiawithliposomalbupivacaine AT scottfduncan treatmentofdigitalischemiawithliposomalbupivacaine AT wcharlessternbergh treatmentofdigitalischemiawithliposomalbupivacaine |