Exparel pain shot for Tummy Tuck. Is it similar to what the dentist gives? Does it have epinephrine?

Question

I am getting the Experal pain shot for a tummy tuck. When I get a shot to numb my mouth from the dentist my heart rate goes up and I feel nervous for about 15 minutes with upset stomach. My dentist always says that a lot of people have that reaction to the epinephrine in the shot. I’m nervous about being put to sleep and an adverse reaction to the Experal pain shot.

Chad Douglas Tattini, MD · Answer

Exparel is a long lasting anesthetic that is typically injected when you are asleep during surgery. I inject into the muscle fascia during abdominoplasties and the incision sites. It usually doesn’t contain epinephrine. It has definitely made a difference postoperatively for my patients.

Ross Blagg, MD · Answer

Hello,The Exparel injection is a long lasting bupivicaine (local anesthetic). It typically lasts around 3 days. It is similar to what many dentists and doctors inject but is longer lasting. It does not have epinephrine and if you've never had a reaction to bupivicaine, you likely will not have a reaction to it. All the best,Dr. BlaggAustin, TX

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  Exparel does not have epinephrine and is rather a combination of a "free" and bound numbing agent that slowly works over 72 hours to minimize the need for prescription pain medications.  You should not get that rush of anxiety that accompanies your dental injections.  Hope this helps.

Kenneth Hughes, MD · Answer

Exparel can be injected at the time of closure for 72 hour pain relief.   Anxiety is fairly common before any procedure. Every surgeon wants his/her patients to have a satisfactory and safe experience. The PS needs to know what your concerns are so that he/she and the anesthesiologist can address your comfort and lessen your anxiety before surgery.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Robert Oliver Jr., MD · Answer

Exparel is similar, but different then what you'd see used at a dentist office for a dental nerve block. It doesn't have epinephine in it , but I would not be concerned even if someone mixed with something that did. With dental blocks, the nerve they inject is adjacent to a vessel. When they plunge the anesthetic in the back of your mouth, dentists frequently inadvertently hit the vessels and you get a bolus of the local into your circulation. It's usually the lidocaine (rather then the epinephrine) that gives you the heart palpitations.

Justin P. Martin, MD, FACS · Answer

Thank you for your question.  Exparel is a long acting local anesthetic (liposomal bupivicane), which can provide pain relief for up to three days.  It is not the same medication that is used by dentists, and does not contain epinephrine.  I would not expect you to have the same reaction to Exparel, but I would let your surgeon know about your reaction to other local anesthetics before your surgery.

Ven Erella, MD · Answer

Thank you for your question. Exparel is different than lidocaine. This is a long acting local anesthetic(Marcaine)  and no epinephrine in it. It works well for many of our TT patients.

Erez Sternberg, MD · Answer

Thank you for asking this excellent question as I feel it is important for patients to understand what Exparel does.  Exparel does not have epinephrine and is rather a numbing agent called Marcaine that is slowly released over time to achieve a constant dose of pain medication at the site of the surgery. It works over 72 hours to minimize the need for additional prescription pain medications.  You should not get that rush of anxiety and racing heart that follow the injection of epinephrine.

Exparel pain shot for Tummy Tuck. Is it similar to what the dentist gives? Does it have epinephrine?

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