Exparel Injection: What are the side effects/risk to getting this injection other than having an allergy to medication?

Question

I am scheduled for TT and BBL surgery. I am considering asking for an Exparel injection to help decrease pain during recovery. What are the side effects/risk to getting this injection other than having an allergy to medication?

Dean Fardo, MD · Answer

Exparel is a safe and very effective long lasting form of local anesthetic.  It will decrease pain post-operatively for up to 3 days and I would recommend it to most patients.  I have yet to see any side effects or complications from its use.  Good luck.

Andrew T. Lyos, MD, FACS · Answer

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 change $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            Tweet

Peter D. Geldner, MD · Answer

Exparel is a long acting form of Bupivacaine. It is a very effective means of controlling pain for two to three days. The risks are rare and mostly due to dose toxicity. That can be due to how it is administered as well as the dose given. As Bupivacaine is metabolized by the liver, people with preexisting liver disease could be at risk. I really like this medication for my tummy tuck patients. It helped reduce their reliance on opioid pain medications (which have a whole bunch of risks). Talk to your surgeon about your concerns, I feel that it's worth the cost.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  Exparel is a long-lasting numbing medication thought to diminish the amount of narcotic pain medication needed during the first three days of recovery.  Outside of allergies, additional risks include the cost of the medication, bleeding/hematoma risks from injecting it into your stomach, and overdosing of the medication if mixed with another numbing agent.  Many patients see dramatic improvement in their pain with its use so be sure to have a thorough discussion with your surgeon.

Hampton A. Howell, MD · Answer

Hi.  As you probably know, Exparel is a slow release formulation of Marcaine, which is a longer acting local anesthetic.  I find Exparel to be a helpful adjunct for pain control.  It can help reduce the amount of narcotic pain medication a patient may need, and likewise make the overall pain control a little better for those first 2-3 days while it is having its effect.  Exparel is expensive, so I don't routinely use it on all cases, but if a patient requested it, and felt that the extra cost was worth it for her or him, then I would typically be fine with using it for that surgery.  I do routinely use it for tummy tucks (or abdominoplasty), though, both for the muscle tightening and the incision.  I find it to be helpful for those cases.  I also like that it is not another device that a patient has to deal with, such as a pain pump; it is absorbed into the tissues where it was injected.  Hope that helps.  Good luck and take care,Dr. Howell

Janet Turkle, MD · Answer

Thank you for your question. Exparel is helpful in slowly, time releasing a local anesthetic (Marcaine) over a two to three day period. This benefits many in reducing the pain due to the muscle repair in tummy tucks and many orthopedic procedures (to name a few of its uses). There are very few risks other than those of an allergic nature which are very rare. Lidocaine should not be injected in the area simultaneously as it can cause all of the Marcaine to be released at once and potentially cause an overdose of the Marcaine.

Paul C. Dillon, MD · Answer

The dose is adjusted based upon the weight of the patient.  It is a very common drug but in a delivery system that causes a very slow release.  Its the new great thing (I rarely say that without proof but this drug is awesome)

Steven Wallach, MD · Answer

Exparel is a medications that is a long term anesthetic in a emulsion that allows for a prolonged effect from the  medication. Besides an allergic reaction, the more common issue is potential bleeding. I do not routinely use it.

Exparel Injection: What are the side effects/risk to getting this injection other than having an allergy to medication?

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