One of the latest trends in surgery and medicine is to reduce our prescribing and use of opiates. Opiates lead to constipation, fogginess, nausea, and most concerning, addiction. An excellent way that we have improved our recovery of our surgical patients is by using a medication called Exparel®. Exparel® is a FDA-approved, liposomal Marcaine derivative that is injected during the surgical procedure and sets during the surgery. Once the patient awakes, the medication is already working and the surgical site is numb and comfortable. Patients are dismissed to return home within 1-2 hours after their surgery and are able to walk around their home and even use the restroom. Early ambulation after surgery is the most effective way to reduce risk for pneumonia and blood clots in the legs. Most of our patients are mothers, working men and women and professionals whose need to return to their families, jobs, and even their workouts is expedited through the use of the Exparel® medication. We have been using Exparel® in combination with oral narcotics for several years and it has revolutionized our patient care significantly. We are pleased to provide this option to our patients at Burt & Will Plastic Surgery and Dermatology.
What is Exparel®?
EXPAREL® is a medication that helps control your pain after surgery so that you can have a good recovery. EXPAREL® is not an opioid or narcotic. It works in your body where you had surgery, unlike opioids, which affect the whole body.
During a procedure, the doctor places EXPAREL® into the surgical area. EXPAREL® contains specially formulated bupivacaine (a type of local anesthetic) that is designed to release into your body over a long period of time for lasting pain relief. Because EXPAREL® works over time, you may need fewer doses of other medications, including opioids. In fact, EXPAREL® is proven to help patients use fewer opioids as they start their recovery.
Which surgical procedures can EXPAREL® be used for?
EXPAREL® can provide relief in many kinds of surgery, including:
- General surgery: Colon, Stomach, Hernia, Kidney, Weight loss
- Orthopedic surgery: Knee, Hip, Spine, Foot, Ankle, Hand, Shoulder
- Oral surgery: Wisdom teeth, Jaw
- OB-GYN / Breast surgery: Hysterectomy, Fibroid, Breast, C-section (Caesarean section)
EXPAREL® can be used in more types of surgery than what is listed here. Talk to your doctor to see if EXPAREL® is right for you.
How does EXPAREL® work?
EXPAREL® numbs the pain in the area on your body where your surgery is performed. EXPAREL® slowly releases a medication (local anesthetic) called bupivacaine. This slow release makes it possible for EXPAREL® to give you long-lasting pain relief after surgery with just a single dose.
How long does EXPAREL® work?
Everyone experiences pain, and pain management, differently. In clinical trials, patients who received EXPAREL® have been shown to experience pain relief during the first few days after surgery.
How is EXPAREL® given?
Your doctor injects EXPAREL® directly into the area of your body where the surgery is being performed, during the procedure. This is the only time you will receive EXPAREL®, so there are no follow-up doses. Because EXPAREL® is used during your surgery, your doctor needs to know ahead of time if it is something you are interested in receiving. Talk about pain management during your consultation so your doctor can plan ahead.
Does EXPAREL® have side effects?
Side effects can occur with any medication; it is important not to ignore anything you might feel. Some patients in clinical trials who received EXPAREL® or other pain relievers experienced nausea, vomiting, fever, and/or constipation. Speak with your doctor right away if you get any of these more frequent side effects, or if you have questions about possible side effects.
Is EXPAREL® an opioid?
No, EXPAREL® is not an opioid medication and is not addictive. EXPAREL® controls pain by releasing a numbing medication slowly and directly in the area of the body where surgery was performed.
When should I speak to my doctor about EXPAREL®?
Since EXPAREL® is something your doctor uses during surgery, it is important to have a conversation with him or her well before your procedure. When you see your doctor for your surgical consultation, make sure to ask about your pain management plan and talk about your needs and preferences.
Will I need to take other pain medications along with EXPAREL®? Can I take other pain medications along with EXPAREL®?
Your doctor may prescribe additional pain medications along with EXPAREL®. Often, doctors will choose to combine medications to try to limit the amount of medicine you need, and therefore limit the risk of side effects. Talk to your doctor about your pain management plan before surgery so you know what to expect.
What does EXPAREL® cost? Does it add to the bill for my surgery?
The charge for EXPAREL® depends on many factors, including: the facility where your surgery happens, the type of surgery, the amount of EXPAREL® you receive, and your insurance coverage. Be sure to discuss this with your doctor and treatment team as you talk about your surgery and post-surgical pain management plan.