EXPAREL in shoulder surgery

Administration volume and technique are critical to achieving optimal results

The videos below include a variety of surgical procedures that demonstrate examples of how to administer EXPAREL for optimal pain control and coverage.

Rotator Cuff RepairPerformed by Dr Sethi

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This video represents an individual clinician experience with and methodology for using EXPAREL.

Pacira BioSciences, Inc., recognizes that there are other methodologies for administering local anesthetics, as well as individual patient considerations, when selecting the dose for a specific procedure.

Please see Important Safety Information below and refer to the Full Prescribing Information.

More Videos

Rotator Cuff Repair

Rotator Cuff Repair Performed by Dr Sethi

Rotator Cuff Repair 2 (Interscalene Brachial Plexus Nerve Block)

Rotator Cuff Repair 2 (Interscalene Brachial Plexus Nerve Block) Performed by Dr Hutchins

Total Shoulder Arthroplasty

Total Shoulder Arthroplasty Performed by Dr Routman

Multimodal protocol and results: shoulder arthroplasty

Study design1

Retrospective study comparing the efficacy of EXPAREL and dexamethasone intraoperatively as part of multimodal pain management (n=31) versus standard multimodal pain management (n=24) in patients undergoing elective shoulder arthroplasty.

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; ISBP, interscalene brachial plexus.