Marcaine vs. exparel? Is one better than the other?

Question

I've been on a few consultations for tummy tuck, some doctors use long acting marcaine, others use exparel. Does one help the pain more than the other? Thank you

Samir S. Rao, MD · Answer

Exparel is a great pain medication if it is available to you.  The only real downside compared to marcaine is the cost.  Marcaine generally lasts about 12 hours, but Exparel is a special formulation of marcaine that allows it to last up to 72 hours.  My recommendation would be to use it if your surgeon recommends it and feels it is appropriate in your case.

Brian K. Reedy, MD · Answer

Thank you for your question! Marcaine and Exparel are very similar local anesthetics however Exparel lasts significantly longer. This means that Exparel can help provide pain relief for about 72 hours whereas marcaine only lasts the day of surgery. The only downside to Exparel is the added expense but I strongly recommend it to my patients for procedures such as a tummy tuck. Hope that helps answer your question!

Joubin Gabbay, MD · Answer

Great question. I feel that exparel is superior over marcaine. They both work the same way, but exparel lasts significantly longer. My patients have had great results with it. I had one patient go out to a coffee shop the night of surgery! This is a decision you should make with your surgeon understanding the benefits and drawbacks of each. Exparel works better, but is more expensive. I wish you the best. Dr. Gabbay.

Dana Khuthaila, MD, FRCSC, FACS · Answer

Thank you for the question. Marcaine has a shorter half life than Exparel. Exparel is basically Marcaine in liposomes and is released slowly to last up to 3 days. The other main difference is the cost. Exparel is more costly than Marcaine. Good luck with your surgery!Dr. Khuthaila

Robert M. Tornambe, MD · Answer

Marcaine works very well and is simple and uncomplicated. Most patients are pain free after a couple of days and the pain Medications are very effective. Good Luck!

Erik Miles, MD, FACS · Answer

Exparel is simply Marcaine that is formulated to be released slowly over time after it is injected.  It typically lasts about 3 days in most patients.  The location of the injections is very important for the anestgetic to be effective.

Matthew Schulman, MD · Answer

Marcaine will control pain for about 8-12 hours.  Exparel is a long-acting marcaine that lasts 3+ days.  I have been using Exparel for several years during all my cosmetic procedures and the pain control has been very very good. Keep in mind, this is not magic. There a specific technique for injecting the medication, so the surgeon needs to be experienced in nerve and regional blocks. The medication is expensive and will add over $300 to the cost of your procedure, so many surgeons will not offer it. Also, many hospitals do not allow it to be used, so if your surgery is being done in a hospital, it may not be an option for you. My advice is to ask your surgeon about Exparel and his/her experience using it.

Barry L. Eppley, MD, DMD · Answer

Exparel is touted as being a long-acting anesthetic that may last up to 3 days. A careful look at their FDA studies, however, indicates that its effect may not be that prolonged. Some now question whether it is really much more effective than that of the traditional use of Marcaine. I have not been that impressed that Exparel has such a prolonged local anesthetic effect.

Jeffrey Zwiren, MD · Answer

Exparel is a long acting marcaine solution mixed with liposomes.  It can last up to 3 days.  In many patients it helps to relieve the early pain after a procedure.  It is useful in patients who have difficulty with pain medications.

Deborah Ekstrom, MD · Answer

If you want an anesthetic in the sheath of the muscle that gets sewn together for tummy tuck surgery, and your doctor plans to use Exparel, Marcaine will be mixed with it to cover the early discomfort, then Exparel will take over.  Although the company says it will last 3 days it usually lasts a little more than 48 hours.  It must be injected into the tissues.  It doesn't work if it just is pooled on the tissues the way a pain pump works.Not all surgical facilities are allowing the use of Exparel yet so it isn't universally available. Sometimes the limitation for allowing it to be used is the cost to the pharmacy of the facility.  Your surgeon is not allowed to bring it to the facility either, usually.That being said the worst discomfort is in the first evening after surgery and Marcaine, which has been used safely for years, will cover that time.

Marcaine vs. exparel? Is one better than the other?

Answers (18)

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