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Exparel study patients likely received additional pain medication, while Exparel
patients received nothing more.
Dr. Onel also says pain studies don't always measure such key benchmarks as
patient satisfaction, opioid usage and discharge time.
"When you look at the studies that have shown Exparel led to a decrease in
discharge, the question becomes: Will you spend a couple hundred dollars to
save a couple thousand dollars?" says Dr. Onel.
An anesthesiologist who was involved with the earlier studies agrees in part.
He says, "I think the drug probably performs better than some of the trials sug-
gest."
Another theory has it that Exparel's showing in studies might relate to how
precisely you must infiltrate it. Exparel's high-tech designer drug delivery mole-
cule, which encloses bupivacaine in the vesicles of an artificial glob of fat so
that the medication will trickle out over time rather than being flushed by the
circulatory system, makes it highly dependent on how it's injected. It doesn't dif-
fuse, so it works best when it's infiltrated into the surgical wound in a very spe-
cific manner.
"Technique is critical," says orthopedic surgeon Thomas Meade, MD, of
Allentown, Pa. "If it's not done correctly, the results are not that good. You have
to think like a sniper, not a shotgun."
OSM
E-mail doconnor@outpatientsurgery.net.
