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EXPAREL Provides Pain Relief When It Matters Most

EXPAREL in Hip Surgery

Multimodal Protocols & Results


Multimodal approaches with or without ERAS protocols have demonstrated benefits in hip surgery

THA
TKA & THA

Multimodal Protocol

Preoperative

  • Celecoxib 200 mg orally
  • Acetaminophen 1000 mg orally
  • Pregabalin 50 mg orally

Intraoperative

Both groups:

  • Spinal (preferred) or general (alternate) anesthesia
  • Injection of bupivacaine HCl 
+ epinephrine 0.25% 40 mL,* morphine sulfate (1 mg/mL) 5 mL, and ketorolac (30 mg/mL) 1 mL

THA + EXPAREL group:

  • Periarticular injection of EXPAREL 266 mg/20 mL in 0.9% saline 40 ml

THA + EXPAREL group:

  • No EXPAREL administered

Postsurgical

  • Patient-controlled analgesia for up to 24 hours after surgery
  • Oral opioid as needed
  • Morphine/hydromorphone HCI intravenously as needed for breakthrough pain

Patients Who Received Multimodal Analgesia With EXPAREL

Significant Pain Reduction

8 hours after surgery (P=0.031)

Fewer
Opioids Used†‡

POD 1 (P=0.001)

POD 2 (P=0.016)

Achieved More Physical Therapy Milestones

Gait: 82% vs 64% (P<0.001)

Stairs: 93% vs 76% (P<0.001)

*The use of EXPAREL in combination with epinephrine is not part of the approved label

Opioid intake measured in MED (mg)

The clinical benefit of the decrease in opioid consumption was not demonstrated in the pivotal trials

MED, morphine equivalent dosing; POD, postoperative day; THA, total hip arthroplasty.

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