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EXPAREL Provides Pain Relief When It Matters Most

EXPAREL in Knee Surgery

Clinical Efficacy


Manage Pain & Minimize Opioids After TKA

EXPAREL vs bupivacaine HCI in TKA1

78% Fewer Opioids*

overall opioid consumption (P=0.0048)

Significantly Better Pain Control

cumulative pain scores (P=0.0381)

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

Pain measured using the visual analog scale

AUC, area under the curve; TKA, total knee arthroplasty; VAS, visual analog scale.

Multimodal Protocols & Results


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

TKA
TKA & THA

Multimodal Protocol

Preoperative

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

Intraoperative

Both groups:

  • Fentanyl (or fentanyl analogs)
  • Spinal anesthesia

EXPAREL group

  • EXPAREL 266 mg/20 mL + 0.5% bupivacaine HCl 20 mL + saline 80 mL

Bupivacaine HCl group:

  • 0.5% bupivacaine HCl 20 mL + saline 100 mL

Postsurgical

  • Celecoxib 200 mg orally every 12 hours until discharge
  • Acetaminophen 975 mg to 1000 mg orally every 8 hours (maximum of 3000 mg/day)
  • Immediate-release oxycodone ≤10 mg orally every 4 hours (maximum) or as needed; if oral therapy was not tolerated, morphine 2.5 to 5 mg intravenously or hydromorphone 0.5 to 1 mg intravenously every 4 hours or as needed

Patients Who Received Multimodal Analgesia With EXPAREL

Less Pain

180.8 vs 209.3 cumulative AUC of VAS 12 to 48 hours after surgery (P=0.0381)

Fewer Opioids*

18.7 mg vs 84.9 mg 
0 to 48 hours 
(P=0.0048)

More Opioids-Free

10% vs 0% in
the first 72 hours (P=0.01)

*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; TKA, total knee arthroplasty; VAS, visual analog scale.

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EXPAREL vs Bupivacaine