Laparoscopic Colorectal Surgery: Medical center in Texas
- 140 patients undergoing laparoscopic colorectal surgery: 70 received an ERP alone, and 70 received an ERP with EXPAREL
- Retrospective observational study
- All patients received the same ERP
- 2.8% of patients in the ERP with EXPAREL group experienced a complication, compared with 7.8% of patients in the ERP-alone group
Clinical and Economic Outcomes
Patients who received ERP with EXPAREL to manage pain after surgery
significantly better pain control
in the PACU*
- 1.92 vs 4.71
fewer opioids consumed over 3 days†
- Day 0: 1.16 vs 3.56 (P<0.001)
- Day 1: 1.31 vs 2.86 (P=0.031)
- Day 2: 1.28 vs 4.91 (P=0.02)
- Day 3: 0.86 vs 2.06 (P<0.001)
had 1 day
- 2.96 days vs 3.93 days (P=0.003)
lower overall costs to the hospital‡
- $11,555.66 vs $12,302.08 (P=0.72)
*Pain was measured using a visual analog scale (0 to 10).
†The clinical benefit of the decrease in opioid consumption was not demonstrated in pivotal trials. Opioid utilization was measured using the World Health Organization’s defined daily dose (DDD), converting each opioid used into the respective DDD (intravenous fentanyl [1 DDD = 100 mcg], intravenous dilaudid [1 DDD = 2 mg], oral dilaudid [1 DDD = 4 mg], oral oxycodone [1 DDD = 20 mg], and hydrocodone [1 DDD = 10 mg]).
‡Costs were defined as the actual per-patient total costs for the entire inpatient episode.
ERP, enhanced recovery protocol; PACU, post-anesthesia care unit; LOS, length of stay.