Exparel may decrease pain & reduces opioid consumption after rotator cuff repair, study shows

Practice Management

Arthroscopic rotator cuff repair patients treated with Exparel consumed 64 percent fewer opioids, according to research presented at the 2018 American Shoulder and Elbow Surgeons Annual Meeting in Chicago, Oct. 11-14.

To learn more about the new CMS rule as well as hear from ASC owners, administrators and leaders in ASC billing and coding on their experiences with Exparel, register for this webinar titled "CMS Reimburses Non-Opioid Postsurgical Pain Management in the ASC: Review of the New CMS Rules and Opportunity for ASCs" on Dec. 4, from 12:00 p.m. to 1:00 p.m.

Greenwich, Conn.-based Orthopaedic and Neurosurgery Specialists Foundation for Clinical Research and Education conducted the study of 50 patients who underwent ARCR. Journals documented the patients' daily pain on a Visual Analogue Scale and tracked their daily opioid consumption for the first five postoperative days.

The study compared a control group of primary ARCR patients given an interscalene block with 0.5 percent bupivacaine to a group of patients who received the same ISB in addition to a field block with Exparel. Pain scores and postoperative opioid consumption data were collected for all patients.

Patients who received Exparel reported lower pain scores on the first two postoperative days and lower overall pain from the procedure

Additionally, 58 percent of Exparel patients stopped opioid therapy four days postoperatively compared with 15 percent of control group patients.

No Exparel patients requested a refill of their opioid prescription during the five-day postoperative period while 28 percent of control group patients requested a refill.

"Our findings suggest that arthroscopic rotator cuff repair patients treated with liposomal bupivacaine along with an interscalene nerve block should be prescribed no more than 25 oxycodone five milligram pills — a stark contrast to the current average amounts prescribed, which a recent report found to be about 93 pills," said ONS President Paul M. Sethi, MD.

"This meaningful reduction in volume of pills prescribed not only helps reduce the risk of opioid addiction or dependence in postsurgical patients, but also the quantity of unused pills in the home, which are often improperly disposed of or stored."

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