EXPAREL Provides Pain Relief When It Matters Most
EXPAREL in Shoulder Surgery
Clinical Efficacy
Manage Pain & Minimize Opioids After Total Shoulder Arthroplasty & Rotator Cuff Repair
EXPAREL vs placebo in ISBP nerve block for total shoulder arthroplasty and rotator cuff repair study1*
78% Fewer Opioids*
overall opioid consumption (P<0.0001)
Significantly Better Pain Control
cumulative pain scores (P<0.0001)
*Rescue opioids for pain were available upon patient request
AUC, area under the curve; ISBP, interscalene brachial plexus; VAS, visual analog scale.
Multimodal Protocols & Results
Multimodal approaches with or without ERAS protocols have demonstrated benefits in shoulder surgery
Multimodal Protocol
Preoperative
Single-injection
interscalene block:
- Acetaminophen 1000 mg intravenously
- Gabapentin 600 mg orally
- Oxycodone 10 mg orally
- Celecoxib 200 mg orally
Intraoperative
Standard multimodal group:
- None
EXPAREL group:
- EXPAREL 266 mg/20 mL + saline 20 mL + 0.25% bupivacaine HCl with epinephrine 10 mL*
- Dexamethasone 8 to 10 mg intravenously
Postsurgical
- Ketorolac intravenously
- Acetaminophen intravenously
- Gabapentin orally
- Oxycodone 5 mg and 10 mg orally for mild to moderate pain
- Hydromorphone 0.5 mg, 1 mg, and 2 mg intravenously for moderate to severe pain
Patients Who Received Multimodal Analgesia With EXPAREL
Lower Pain Level
3.5 vs 7.5 VAS pain score on POD 1 (P<0.001)
Fewer Opioids Used in PACU*†
20 mg vs 40.5 mg in cumulative utilization (P<0.001)
Shorter LOS
1 day vs 2 days (P<0.001)
*The use of EXPAREL in combination with epinephrine is not part of the approved label
†Opioid intake measured in MED (mg)
LOS, length of stay; MED, morphine equivalent dosing; POD, postoperative day; VAS, visual analog scale.
