Nurse and patient smiling as patient is discharged from hospital post-nerve block surgery

Clinical and economic value outcomes with EXPAREL

Cost & Value

EXPAREL is available in 133 mg (10 mL) for $180.35 and 266 mg (20 mL) doses for $334.18. The 133 mg (10 mL) and 266 mg (20 mL) doses of EXPAREL are available in cartons of 4 and 10 vials. For more information please visit How to order EXPAREL.

Information below helps review the value of EXPAREL in a multimodal pain management protocol that can lead to fewer opioids, better pain control, and shorter length of stay (LOS). These, in turn, can lead to fewer patient complications and reduced hospital costs per patient.

Total Hip Arthroplasty Study1: ASCs in Tennessee

Study Methods

  • 145 outpatient THAs in 125 patients performed with the use of EXPAREL® (bupivacaine liposome injectable suspension) by a single surgeon in 2 separate stand-alone ASCs
  • Retrospective chart review

Safety Outcomes

  • 1 recognized intraoperative fracture, which did not compromise same-day discharge
  • 5 unanticipated complications (3.4%) in global period postsurgery

Clinical and Economic Outcomes

In patients who received EXPAREL for analgesia
  • Complication rates

    compared favorably

    with those reported after standard inpatient THA

  • 99.3%

    of cases did not
    require a transfer
    to the hospital
    for transfusion

    • 0% of patients required other direct admissions to the hospital or ED
  • Average
    surgical time was

    71 minutes

    and total LOS was
    10.8 hours

  • 98%

    of cases did not
    require a surgical
    intervention within a
    90-day period

    • Persistent drainage 6 weeks postsurgery that required debridement/irrigation with head/liner exchange
    • Periprosthetic fracture from a same-level fall at home 7 days postsurgery that required revision surgery
    • Outpatient superficial wound revision, 4 weeks postsurgery

THA (N=145)

  • Preoperative regimen
    • Oral celecoxib 400 mg, gabapentin 300 mg, oxycodone 10 or 20 mg, and oral or intravenous acetaminophen 1000 mg
  • Intraoperative regimen
    • 0.75% bupivacaine with 8.25% dextrose 10 to 15 mg spinal, EXPAREL 266 mg infiltrated into wound, and intravenous dexamethasone 4 to 8 mg
  • Postsurgical regimen
    • Oral celecoxib 200 mg 4 times daily or meloxicam 7.5 mg 2 times daily, oral gabapentin 300 mg 2 times daily, oral tramadol 50 mg every 6 hours, oral acetaminophen 1000 mg every 8 hours, and oral oxycodone 5 to 10 mg every 4 to 6 hours as needed
  • Spinal anesthesia was used in 132 procedures with bupivacaine (10.5-15 mg) and general endotracheal anesthesia was used in 13 patients due to previous spinal fusion, preexisting neuropathy, or intraoperative conversion secondary to unsuccessful spinal anesthesia
  • Included 105 unilateral procedures and 20 bilateral procedures

ASC, ambulatory surgery center; ED, emergency department; LOS, length of stay; THA, total hip arthroplasty.