Total Knee Arthroplasty: 16 US centers
- 139 patients who received a TKA, with 70 receiving EXPAREL and 69 who did not
- Phase 4 clinical trial
- Both treatments were well tolerated, with most adverse events mild or moderate. One patient in each group experienced a serious adverse event, with both events deemed unrelated to the study medication
Clinical and Economic Outcomes
In patients who received EXPAREL for analgesia
better pain control
12 to 48 hours
reduction in opioid
use 0 to 48 hours
free of opioids
at 72 hours
- Preoperative regimen
- Acetaminophen 1000 mg, celecoxib 200 mg, oral pregabalin 300 mg, and intravenous tranexamic acid 1 g within 4 hours before surgery
- Intraoperative regimen
- Fentanyl or its analog
- Postsurgical regimen
- Oral acetaminophen 975 to 1000 mg every 8 hours, oral celecoxib 200 mg every 12 hours, rescue analgesics as needed (oral immediate-release oxycodone ≤10 mg every 4 hours or as needed, intravenous morphine 2.5 to 5 mg or hydromorphone 0.5 to 1 mg every 4 hours or as needed if oral medication was not tolerated). Rescue medications were received upon patient request for analgesia
TKA WITH EXPAREL (n=70)
- Local infiltration with EXPAREL 266 mg/20 mL admixed with bupivacaine HCl 0.5%, 20 mL, expanded with saline to a total volume of 120 mL
TKA WITHOUT EXPAREL (n=69)
- Local infiltration with bupivacaine HCl 0.5%, 20 mL, expanded with saline to a total volume of 120 mL
*Pain measured using visual analog scale.
†The clinical benefit of the decrease in opioid consumption was not demonstrated in the clinical trials.
‡Compared with 0% of patients who received bupivacaine HCl alone.
TKA, total knee arthroplasty.