Why are doctors not willing to use Exparal Pain Relief?

I was one of the first surgeons on Long Island to use a pain pump for a TT over ten years ago and I swore by them. 1 1/2 years ago i tried Exparel for the first time and there is no comparison. I got rid of all the leftover pain pumps. The drug costs about $300 per patient but when you consider all the benefits of little to no narcotic use after surgery, it is well justified. It is true that hospitals and ambulatory facilities are very hesitant to buy it. Recent studies have shown that it actually results in shortened hospital stays.I have my own Joint Commission accredited office based surgical facility so i can buy whatever I choose. I will not even consider doing a TT without it. It is not an option. The cost of the drug is simply built into our facility fee.

Thanks for your question -  You should ask your plastic surgeon why they choose not to use Exparel.  It is a relatively new drug and sometimes that makes some doctors uncomfortable.  But its the patient comfort they should consider here.  Exparel works wonderfully to manage post-op pain for several days.  We have started offering it to all of our patients who get procedures like Tummy Tucks.Unlike narcotics it doesn't have potential for addiction, constipation or nausea.Our patients love it.

Hello! Thank you for your question! Exparel is an excellent form of
delivery of a local anesthetic, Marcaine. It is delivered within a
liposomes form, which is slowly released over a 72 hour period. The
injectable form lasts approximately 6 hours. It has significantly
reduced postoperative pain as well as the need for postoperative
narcotics following surgical procedures. Sometimes a small additional
fee is required for it's use, but it's benefits have been great. The
pain pumps are excellent as well as they continuously drip the
anesthetic within the pocket. Typically, Exparel is either
injected into the surrounding soft tissue/underlying muscle layer or
just simply released into the pocket itself. If injected between the
ribs, there certainly is a theoretical, and higher, risk of puncturing
of the lung. the former methods are more common. Discuss its access as well as potential use for you with your surgeon.  Hope that this helps!
Best wishes!

I have used Exparel routinely with tummy tucks since it first became available and it has made a big difference. Since you are paying out of pocket for a tummy tuck there is no reason that I can see why it could not be made available.

I switched from pain pumps to Exparel for tummy tucks as have many other surgeons. Maybe if there is enough demand the surgeons in your area will start using it. Look for a Board Certified Plastic Surgeon that has his/her own surgery center as some hospitals might not supply it. Keep looking you may find one. Good luck!

I have switched to Exparel- which- if injected correctly provides very good pain relief for up to three days. I no longer use pain pumps and prefer not to have extra fluid draining internally and the extra apparatus. The price is included in my fee. You still require oral narcotics but I have been finding less need for them.