Table 2.

Summary of liposomal bupivacaine application

Author	Study design	Result
McAlvin et al. [51]	To evaluate the effect of liposomal bupivacaine on the sciatic nerve in experimental models	Histological evaluation reported that both Exparel complex and bupivacaine hydrochloride produce tissue reaction with the liposomal complex being less aggressive.
Lonner et al. [52]	To study the role of liposomal bupivacaine in pain management after total joint arthroplasty and observed that liposomal bupivacaine pharmacokinetics and pharmacodynamics	Liposomal bupivacaine has less cardiac toxic effects, less cardiac toxic effects, without significant differences between Exparel™ and placebo: palpations and extrasystoles (≤2 %), tachycardia (3.9 %), bradycardia (1.6 %), hypertension and hypotension (≤2 %).
Richard et al. [53]	To study any hematological, biochemical, and biological side effects of Exparel complex in laboratory animals	(1) Histological analysis reported that there was evidence of granulomatous inflammation, 15 days after administration of Exparel™ formulation. (2) There was maintenance of optimum plasma concentration for about 96 h. (3) Administration of liposomal bupivacaine to postoperative patients reduces the intake of opioids, the hospital admission period, and costs of bills.
Soberón et al. [49]	Study was carried out on a 45-year-old woman with digital ischemia on the ring finger and little finger at the right hand.	(1) It was reported that the results were superior to the subclavicular block due to a better and efficient pain control. (2) It was reported that after surgery, photo-plethysmography, showed a normal ulnar artery and loss of finger cyanosis, as a result of vasodilation effect produced by liposomal bupivacaine.