Pain pump and Exparel?

This is a fantastic question, although the answer will depend on which surgery you're planning to undergo which I don't see included in your question above. In general you are correct, Exparel has replaced the use of pain pumps in many circumstances (universally in my practice) and is great because you don't have a pump coming out of you after surgery. Also, Exparel can be injected into many different locations instead of dripping into just one area like the pain pump does. Exparel is an amazing drug, that has completely transformed post-operative pain and recovery in my patients undergoing breast and abdominal surgery. In breast cases I uses it to numb all the nerves in between the ribs so both chests are covered and in abdominal cases inject in many locations, essentially numbing the whole abdomen. For cosmetic cases, most surgeons will charge extra since it is very expensive, but the patients say they'd easily pay double after experiencing the effect vs what is typical with their respective surgery. I've never personally used or heard of anyone using exparel and a pain pump - to me that seems unnecessarily redundant, wasteful and a hassle for the patient.Regarding your specific situation, don't worry about your acetaminophen (tylenol) allergy. It's the least powerful pain medicine there is. Most narcotics come as a combo with it, however the narcotic medicine alone can be prescribed to avoid the acetaminophen. In addition to narcotic pain meds, I always write my breast and abdominal patients for valium which is a muscle relaxant and really helps with the muscle spasm and discomfort after surgery - many patients in fact say this is more helpful than the narcotic. The combination of these 2 drugs should be more than enough (especially if Exparel is used). You could also potentially take ibuprofen (motrin/advil) a few days after surgery, but you would need to clear this with your surgeon beforehand since it can cause bleeding in certain cases.Overall, I can't recommend Exparel enough, if it were me or a family member I wouldn't consider major breast or abdominal surgery without it. And for your post-op pain control, you'll be more than fine even though you can't take acetaminophen due to your allergy. Best of luck!

Hello and thank you for your question.I use Exparel for many of the procedures I offer.  Most of my patients elect to use Exparel for tummy tucks, body lifts, and breast reduction. The medication is injected at the time of surgery and lasts for 3 days.  It has been particularly helpful for our tummy tuck patients in that it allows them to get up and around more quickly.  Most surgical facilities will charge $350-400 for the 20 ml vial.  There is now a 10 ml vial available which should be half the cost and is perfect for case such as breast augmentation. Possible side effects with patients who received  Exparel and with other pain relievers can experience nausea, vomiting, and/or constipation. If it is not available, I have used the pain pump with good results.Best Wishes, Andrew Lyos MD FACS

Just Exparel is what we recommend!  Pain pumps and adding other local anesthetic medications is contraindicated.  Skip the pump.  You should be fine on the pain medications that can be prescribed that don't have Acetaminophen.  Best Wishes!!

There are certainly many pain medications that do not contain acetaminophen that you can probably use after surgery. Pain pumps and Exparel can be useful, but typically are not necessary. My experience with Exparel is that it does work, but not quite as well as the company that sells it would like for you to believe. The same is true with the pain pumps. Depending upon the surgery you are considering, you could probably do just fine with an isolated narcotic (oxycodone, hydrocodone) along with a NSAID (ibuprofen, advil, alleve, etc.).

Exparel works very well to help control pain the first days after surgery.  It can be combined with oral pain medication for pain management.  There are several medications available that do not contain acetaminophen.  Your surgeon will pick one that he/she feels will work best for you. If you have not yet selected a surgeon, we welcome you to visit our office for a consultation!