On cloud 9 - just learned about Exparel!

Exparel is an injectable 72 hour lasting anesthetic/nerve blocker that costs a boatload (surgeon thinks maybe $375) but SIGNIFICANTLY lowers the pain for the first three days out of surgery.

Seeing as I live daily in terror of what the pain "might" be like after my LBL and BL on March 20th, learning about the existence of Exparel pretty much made my life!!!  I am definitely going to get it.  If I can wake up and not want to die of pain, I am on board!

I searched the site here and it's posted about, but not very often.  So just in case you haven't heard about it, check it out!

the nerves in the skin are cut and I didn't feel very much pain at all. More slight soreness.

i think I would save my money but of course we are all different.

I think Holly due to the epidural and the lasting effects of the pain meds that Mrs Dr S pushes through, our pain is managed for a few days, so that when we go to the oral meds, there isn't much pain.  I didn't notice very much pain, more discomfort. 

Although, I've seen lots of posts here about folks in incredible pain.  That was another reason for me for going to Dr Sauceda as I'm a real pain weanie.  I had more pain with my DS, than I did with my LBL, BL, arms and sm thigh.

interesting,thanks for clarifying. I often wondered why so many others said it was so excruciating for them. We were/are lucky,aren't we,in more ways than one!

My experience was that the exparel was a good thing.  I'd spring for it again in a heartbeat.

my doctor uses exparel and I ran out and bought  1 share of stock, LOL.  It has gone up from $75 to about $100 a share.  Only wish I had more money to invest in this!

I think getting local anesthesia into the surgical site is very helpful in minimizing pain and lowering the amount of narcotics needed.  I administer this through a pain pump system, which is a tube coming out of the body, and so it is a bit of a hassle.  Over 10 years of use, I have had one or two patients develop reactions to the medications and the pump was shut off.

My issue with Exparel is that its only been researched and approved for use in small areas (bunions and hemorrhoids) as a single dose, and it lasted just 24 hours in both groups. The medication is not new (bupivicaine) its just encapsulated to last longer. I am concerned that the doses used to cover the huge areas in a body lift or TT may be excessive.  I infuse 300cc of Ropivicaine over 2.5 days in my TT and LBL patients.  The maximum dose tested of Exparel is 20cc.

My concern is that if a patient developed a reaction, how would you withdraw the drug ? There is no way to "shut it off" and a patient may well be at home if issues come up.

Exparel overview

http://www.centerwatch.com/drug-information/fda-approved-drugs/drug/1172/exparel-bupivacaine-liposome-injectable-suspension/?mp=aafa

Bupivicaine side effects

http://www.drugs.com/sfx/bupivacaine-side-effects.html

If you are receiving a continuous dose of any medication, its important for you to know the side effects and seek medical advice right away. 

I never mean to rain on the parade, but when I was a physician consultant for Jenny Craig back in the long ago, there was a drug called Phen-Fen that was being used commonly. Years later, a miracle pain drug came along called "Vioxx."  Its not a good feeling to know you gave these to your patients after being reassured they were safe by the company. I may well use Exparel in the future, but I want more experience and research with it first.

Thanks Dr. L for giving us a physician's viewpoint on this drug.  Good information.

(Yes - I was a Phen - Fen patient for awhile until my blood pressure shot through the roof - got off that medication early thank goodness!).