Remimazolam for general anaesthesia – first line

Liposomal bupivacaine is in late-stage clinical development for the treatment of postoperative pain in adults. Post-operative pain is a common occurrence for those patients who have surgery. Controlling post-operative pain is important for ensuring a good patient experience, optimising post-operative outcomes and enhancing recovering, and the prevention of chronic postsurgical pain in the longer term.

Bupivacaine and meloxicam (HTX-011) in a fixed-dose combination is in development for the management of post-operative pain. Post-operative pain is a typical example of acute pain. Acute pain typically lasts for less than 3-6 months (unlike chronic pain which carries on for longer than 12 weeks), and is provoked by identifiable stimuli and disappears as soon as the tissue injury or damage that had caused it is healed. All surgical procedures are associated with a certain level of post-operative pain. Opioids are often used to manage post-operative pain but carry the risk of harmful side effects, abuse and addiction.

Tanezumab is in clinical development for the treatment of moderate to severe chronic pain associated with osteoarthritis and chronic low back pain. Pain is an unpleasant sensory experience associated with damage to body tissues due to an injury, physical pressure, or inflammation of some part of the body. Chronic pain is persistent or recurrent and lasts for longer than 12 weeks. Moderate pain interferes significantly with daily living activities, and severe pain is disabling and causes an inability to perform daily living activities. Effective long-term treatment options for managing moderate to severe chronic pain are limited. Currently available pain medicines like opioids and analgesics may increase the risks of addiction, gastrointestinal, cardiovascular and renal problems.

Rimegepant potentially offers an alternative to current agents, particularly for patients who have contraindications to the use of triptans. This includes patients with underlying cardiovascular diseases, or who either do not respond or have inadequate or inconsistent response to triptans or are intolerant to them.