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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE


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All Clinical Trials for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00008476 ↗ Capsaicin to Control Pain Following Third Molar Extraction Completed National Institute of Dental and Craniofacial Research (NIDCR) Phase 2 2001-01-01 This study will test the effectiveness of the drug capsaicin in controlling pain after third molar (wisdom tooth) extraction. Capsaicin, the ingredient in chili peppers that makes them "hot," belongs to a class of drugs called vanilloids, which have been found to temporarily inactivate pain-sensing nerves. Healthy normal volunteers between 16 and 40 years of age who require third molar (wisdom tooth) extraction may be eligible for this study. Participants will undergo the following procedures in three visits: Visit 1: Patients will have touch (sensory) testing by the following three methods: 1) a warm sensor applied to the gums and the patient will rate when they first feel heat and when the heat feels painful; 2) the bristles of a small paint brush will be gently stroked across the gums, and the patient will say whether it feels painful; 3) a light touch will be applied to the gums with a small needle, and the patient will rate the pain intensity following the touch. After testing, patients will be numbed with a local anesthetic (bupivacaine) and then capsaicin or placebo (an inactive solution) will be injected next to the tooth. The tooth then will be extracted one day later. Visit 2: Patients will return to the clinic after 24 hours to repeat the same type of sensory testing. After testing, patients will be sedated and numbed with a local anesthetic (lidocaine) and given an intravenous injection of either saline or ketorolac (30 mg). After the extraction, pain ratings will be recorded every 20 minutes, for up to 6 hours. During this time, patients will be monitored for numbness, pain, side effects and vital signs (heart rate, blood pressure, respiration, etc.). Those who request pain medicine will receive acetaminophen and codeine. Patients will be required to stay for up to 3 more hours after this and then they will then be discharged with pain medicine. Visit 3: Patients will return to the clinic after another 48 hours to repeat the same sensory testing. Remaining wisdom teeth will be removed "off-study" at least three weeks following the first visit.
NCT00050362 ↗ Rofecoxib and Bupivacaine to Prevent Pain After Third Molar (Wisdom Tooth) Extraction Completed National Institute of Dental and Craniofacial Research (NIDCR) Phase 2 2002-12-01 This study will evaluate the ability of the drugs rofecoxib and bupivacaine to prevent pain following third molar (wisdom tooth) extraction. Rofecoxib is approved to treat pain of arthritis and menstrual cramps. Bupivacaine is a local anesthetic similar to lidocaine, but longer acting. Healthy normal volunteers between 16 and 35 years of age who are in general good health and require extraction of their two lower wisdom teeth may be eligible for this study. Participants will have their two lower wisdom teeth extracted, and a biopsy (removal of a small piece of tissue) will be taken from the inside of the cheek around the area behind one of the extraction sites. Ninety minutes before surgery, patients will take a dose of either rofecoxib, or a placebo (a pill with no active ingredient) by mouth. Just before surgery, they will receive an injection of either lidocaine or bupivacaine to numb the mouth and a sedative called midazolam (Versed® (Registered Trademark)) through an arm vein to cause drowsiness. After surgery, a small piece of tubing will be placed into one of the two extraction sites. Samples will be collected from the tubing to measure chemicals involved in pain and inflammation. Patients will remain in the clinic for up to 4 hours after surgery to monitor pain and drug side effects while the anesthetic wears off. During this time, they will complete pain questionnaires every 20 minutes. (Patients whose pain is unrelieved an hour after surgery may request and receive acetaminophen (Tylenol) and codeine.) The tubing then will be removed and they will be discharged with pain medicines (Tylenol, codeine and the study drug) and forms to record pain ratings. They will be given detailed instructions on how and when to take the medicines and how to record information in the pain diary. Patients will return to the clinic 48 hours after surgery with the pain diary and pain relievers. At this visit, another biopsy will be taken under local anesthetic (lidocaine).
NCT00458003 ↗ Phenylephrine in Spinal Anesthesia in Preeclamptic Patients Completed Northwestern University N/A 2006-07-01 Hypotension remains a common clinical problem after induction of spinal anesthesia for cesarean delivery. Maternal hypotension has been associated with considerable morbidity (maternal nausea and vomiting and fetal/neonatal acidemia). Traditionally, ephedrine has been the vasopressor of choice because of concerns about phenylephrine's potential adverse effect on uterine blood flow. This practice was based on animal studies which showed that ephedrine maintained cardiac output and uterine blood flow, while direct acting vasoconstrictors, e.g., phenylephrine, decreased uteroplacental perfusion. However, several recent studies have demonstrated that phenylephrine has similar efficacy to ephedrine for preventing and treating hypotension and may be associated with a lower incidence of fetal acidosis. All of these studies have been performed in healthy patients undergoing elective cesarean delivery. Preeclampsia complicates 5-6% of all pregnancies and is a significant contributor to maternal and fetal morbidity and mortality. Many preeclamptic patients require cesarean delivery of the infant. These patients often have uteroplacental insufficiency. Given the potential for significant hypotension after spinal anesthesia and its effect on an already compromised fetus, prevention of (relative) hypotension in preeclamptic patients is important. Spinal anesthesia in preeclamptic patients has been shown to have no adverse neonatal outcomes as compared to epidural anesthesia when hypotension is treated adequately. Due to problems related to management of the difficult airway and coagulopathy, both of which are more common in preeclamptic women, spinal anesthesia may be the preferred regional anesthesia technique. Recent studies have demonstrated that preeclamptic patients may experience less hypotension after spinal anesthesia than their healthy counterparts. To our knowledge, phenylephrine for the treatment of spinal anesthesia-induced hypotension has not been studied in women with preeclampsia. The aim of our study is to compare intravenous infusion regimens of phenylephrine versus ephedrine for the treatment of spinal anesthesia induced hypotension in preeclamptic patients undergoing cesarean delivery. The primary outcome variable is umbilical artery pH.
NCT00484159 ↗ Efficacy and Cost: Benefit Ratio of 0, 1, and 2 Medial Branch Blocks for Lumbar Facet Joint Radiofrequency Denervation Completed Johns Hopkins University N/A 2007-02-01 Lumbar zygapophysial (facet) joint pain is a common cause of low back pain. Radiofrequency (RF) denervation is an effective and low risk treatment of chronic low back pain of suspected facet joint etiology. Blocks of the medial branches innervating the joints are commonly used to localize the pain and make the diagnosis of facet joint pain. There is currently no standard number of diagnostic blocks: zero, one, and two blocks have all been utilized. Considering the high false positive and false negative rates of these blocks, the cost: benefit ratio has been questioned. No study to date has examined the practice of diagnostic medial branch blocks before RF denervation. The purpose of this study is to determine the optimal number of blocks before radiofrequency denervation. Three groups of patients will be studied. In group I, patients will undergo RF denervation based on history and physical exam alone. In group II, patients will undergo RF denervation based on a positive response to a single diagnostic block with local anesthetic. In group III, patients will undergo RF treatment only after a positive screening block and a positive confirmatory block.
NCT00487084 ↗ Effect of Timing on Efficacy of Morphine Analgesia After 2-chloroprocaine Anesthesia Completed Northwestern University N/A 2004-08-01 Epidural chloroprocaine is often used in obstetrical anesthesia because of its fast onset and short duration. These properties make it an ideal drug to use for epidural anesthesia in patients undergoing postpartum tubal ligation. When epidural morphine is given after chloroprocaine, there is a decreased efficacy of analgesia as compared to lidocaine (1). Several studies have hypothesized a specific opioid receptor mediated antagonism of chloroprocaine (2,3). Karambelkar raised the question whether this decreased efficacy is due to a disparity between the time the chloroprocaine anesthesia resolves and the onset of epidural morphine analgesia, resulting in a time window of pain (2). The duration of action of epidural 2-CP anesthesia is 30-45 minutes and the onset of epidural morphine analgesia is 60-70 minutes, therefore the regression of sensory blockade before the onset of the morphine analgesia could result in a window of pain (2). Hess and colleagues studied epidural morphine analgesia and women who had a Cesarean delivery under spinal bupivacaine anesthesia (3). Subjects were randomized to receive epidural 2-CP and morphine or epidural saline and morphine. There was no difference in postoperative analgesia between the two groups (3 and personal communication, Dr. Philip Hess). A literature search cross referencing epidural chloroprocaine, using Pub Med, did not produce any articles comparing epidural morphine given before the procedure (in an attempt to time the onset of analgesia with the resolution of chloroprocaine anesthesia) to the standard administration time after the procedure.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE

Condition Name

Condition Name for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE
Intervention Trials
Pain, Postoperative 28
Postoperative Pain 18
Pain 16
Anesthesia, Local 13
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Condition MeSH

Condition MeSH for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE
Intervention Trials
Pain, Postoperative 64
Acute Pain 14
Hypotension 13
Labor Pain 7
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Clinical Trial Locations for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE

Trials by Country

Trials by Country for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE
Location Trials
United States 98
Egypt 49
Canada 20
Turkey 12
Pakistan 5
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Trials by US State

Trials by US State for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE
Location Trials
California 12
New York 8
Texas 8
Ohio 8
Pennsylvania 8
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Clinical Trial Progress for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE

Clinical Trial Phase

Clinical Trial Phase for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE
Clinical Trial Phase Trials
PHASE4 9
PHASE3 2
PHASE2 5
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Clinical Trial Status

Clinical Trial Status for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE
Clinical Trial Phase Trials
Completed 130
Recruiting 56
Unknown status 24
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Clinical Trial Sponsors for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE

Sponsor Name

Sponsor Name for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE
Sponsor Trials
Tanta University 8
Cairo University 8
Assiut University 7
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Sponsor Type

Sponsor Type for BUPIVACAINE HYDROCHLORIDE; LIDOCAINE HYDROCHLORIDE
Sponsor Trials
Other 333
U.S. Fed 11
Industry 5
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Clinical Trials Update, Market Analysis, and Projection for Bupivacaine Hydrochloride and Lidocaine Hydrochloride

Last updated: October 30, 2025


Introduction

Bupivacaine hydrochloride and lidocaine hydrochloride are widely utilized local anesthetics with extensive clinical and commercial applications. Both drugs are integral to pain management in surgical, dental, and specialized regional anesthesia. The evolving landscape of clinical research, coupled with increased demand for effective pain control, underscores the importance of analyzing recent developments, market dynamics, and future projections for these agents.


Clinical Trials Landscape

Current Status and Trends

Recent years have seen a surge in clinical trials exploring novel formulations, delivery mechanisms, and expanded indications for bupivacaine and lidocaine. The primary focus remains on enhancing safety profiles, prolonging anesthetic duration, and reducing cardiotoxicity risk associated with traditional formulations.

Bupivacaine Hydrochloride

  • Extended-Release Formulations: Multiple trials are investigating liposomal and other nano-carrier systems to prolong duration, thus reducing dosing frequency. For example, Pacira BioSciences has developed a liposomal bupivacaine, EXPAREL, which has garnered FDA approval in multiple regions for postsurgical analgesia.
  • Safety Profile Enhancements: Innovative formulations aim to minimize cardiotoxicity, a known risk, particularly with high-dose or inadvertent intravascular injection. Trials are evaluating lower-dose regimens and adjuncts that mitigate systemic absorption.

Lidocaine Hydrochloride

  • Novel Delivery Systems: Continuous infusion devices, patch formulations, and topical gels are under development to improve patient compliance and expand outpatient applications.
  • Expanded Indications: Trials are exploring lidocaine's utility in neuropathic pain, such as postherpetic neuralgia, and systemic uses like intravenous lidocaine for chronic pain management, reflecting its versatile profile.

Regulatory and Clinical Trial Highlights

  • The FDA has approved certain formulations, but ongoing trials aim to broaden indications and improve safety metrics.
  • The European Medicines Agency (EMA) is actively reviewing extended-release formulations, emphasizing the need for more comprehensive safety data.

Market Analysis

Market Size and Growth Drivers

The global local anesthetics market, valued at approximately USD 2.5 billion in 2022, is projected to grow at a CAGR of 7% through 2030 [1]. Dynamics influencing this growth include:

  • Increasing surgical procedures worldwide, especially in emerging markets.
  • Rising adoption of regional anesthesia over general anesthesia due to safety and recovery benefits.
  • Advancements in drug formulations that extend analgesic duration and improve safety.

Bupivacaine Hydrochloride

  • Market Penetration: As a long-standing standard, bupivacaine dominates the local anesthetic market for intraoperative and postoperative pain management.
  • Innovation Impact: Extended-release formulations like EXPAREL have carved a niche in post-surgical analgesia, projected to expand market share significantly.

Lidocaine Hydrochloride

  • Versatile Applications: Fitting into a broad spectrum from minor dermatological procedures to systemic pain control. The topical and patch formulations bolster outpatient care.
  • Market Expansion: Growing trend toward perioperative pain management protocols favors lidocaine's increasing utilization.

Competitive Landscape

Key players include:

  • Pacira Biosciences: Leader with EXPAREL (liposomal bupivacaine).
  • Heron Therapeutics: Developing generic versions and novel formulations.
  • AstraZeneca, Mylan, Pfizer: Traditional manufacturers with established product portfolios.

Emerging companies focus on biosimilars and innovative delivery systems, intensifying market competition.

Market Projections

Short to Medium Term (2023–2027)

  • Steady Growth: Both agents are expected to maintain growth trajectories driven by technological innovation. The demand for safer, longer-lasting formulations will underpin expansion.
  • Adoption in Emerging Markets: Rapid healthcare infrastructure development in Asia Pacific, Latin America, and Africa will contribute to increased utilization.

Long-Term Outlook (2028–2033)

  • Innovation-driven Growth: Enhanced formulations, including biodegradable carriers and targeted delivery systems, will redefine the market.
  • Expanding Indications: Systemic applications and new therapeutic uses, such as chronic pain and nerve blocks, are poised to drive significant volume increases.
  • Regulatory Landscape: Stringent safety standards and approvals will influence development timelines and market entry.

Challenges and Opportunities

Challenges

  • Safety Concerns: Cardiovascular and neurotoxicity risks necessitate vigilant monitoring and innovative solutions.
  • Pricing and Reimbursement: Cost-effectiveness of novel formulations may impact adoption, especially in resource-limited settings.
  • Regulatory Hurdles: Stringent approval pathways can delay commercialization of innovative products.

Opportunities

  • Personalized Medicine: Tailoring formulations based on patient-specific needs.
  • Technology Integration: Integration with wearable or smart devices for controlled release.
  • Global Expansion: Access expansion into underserved markets through strategic collaborations.

Conclusion

Bupivacaine hydrochloride and lidocaine hydrochloride continue to be pivotal in anesthesia and pain management, supported by ongoing clinical research and market innovation. The future landscape is characterized by extended-release formulations and expanded indications, promising sustained growth driven by technological advancements and increasing global healthcare demands.


Key Takeaways

  • Innovative Formulations: Advanced delivery mechanisms, notably liposomal and nano-encapsulated systems, are transforming the therapeutic landscape.
  • Market Growth: The local anesthetics market is projected to expand at a CAGR of approximately 7%, driven by ongoing clinical innovations and increased procedural volume globally.
  • Regulatory Outlook: Enhanced safety profiles and evidence from ongoing trials are critical to market acceptance and regulatory approvals.
  • Emerging Opportunities: Expanding into systemic pain management and specialized indications presents significant growth avenues.
  • Strategic Focus: Companies investing in R&D, safety profiling, and strategic partnerships are positioned for competitive advantage.

FAQs

1. What are the primary differences between bupivacaine and lidocaine in clinical use?
Bupivacaine offers longer-lasting anesthesia due to its higher lipid solubility, making it suitable for post-operative pain management. Lidocaine provides a quicker onset with a shorter duration, often used in minor procedures and as a topical agent.

2. How are novel formulations improving the safety profiles of these drugs?
Extended-release systems and targeted delivery reduce systemic absorption and peak plasma concentrations, decreasing risks such as cardiotoxicity associated with traditional formulations.

3. What regulatory challenges do new formulations of these drugs face?
New formulations undergo rigorous safety and efficacy evaluations. Demonstrating advantages over existing products and establishing long-term safety are crucial, potentially prolonging approval timelines.

4. How significant is the role of emerging markets in the growth of these drugs?
Emerging markets contribute substantially to market expansion due to increasing healthcare infrastructure, procedural volume, and adoption of regional anesthesia techniques.

5. What is the outlook for systemic applications of lidocaine?
Intravenous lidocaine for chronic pain and systemic analgesic uses are gaining traction, supported by clinical evidence, opening additional revenue streams and expanding clinical indications.


Sources:
[1] MarketResearch.com, "Global Local Anesthetics Market Size & Share," 2022.

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