Pain pump vs. Exparel. Is one medication actually better or just less of a hassle because you don't have to wear the pump?

Is Exparel or the pain pump more effective at combating pain? I know people like Exparel because they don't have to wear the pump, but is that the only difference? Do they both combat pain to the same degree?

Doctor Answers 9


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I had used pain pumps for years, especially for abdominoplasties. However, the constant infusion of medication (fluid) adds to and prolongs the drainage period. Also, they are cumbersome/ "in the way". The Exparel is extremely convenient, requires no maintenance or care, and doesn't prolong the time in which the drains stay in. Therefore, the advances of Exparel  are significant  and the only drawback is the price... which is not negotiable.

Pain pumps

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Pain pumps really don't work that well.  Most lasting surgical procedures aren't so painful to justify the cost of exparel in my opinion.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Pain Control

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I presume this is for abdominoplasty.  Exparel has been shown to be similar in pain control to anesthetic infusion pumps but without the inconvenience and potential complications of tubes.  Having said that, I use neither, and prefer to inject with a local anesthetic (the same medicine in Exparel) directly into the muscle wall where the nerves exist as they travel to the midline. This works very well, and is much less costly. 
Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

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Pain control for tummy tuck

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Pain control for  #tummytuck
we switched to exparel two years ago and it is a much better choice for both pain and ease of use.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Pain pump vs. Exparel.

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There is no correct answer so you will get pros or cons for each depending on each surgeon's preference. I personally prefer a pain pump that lasts for four days. The patients with the pump do dramatically better than those without. It costs about the same as Exparel, but we get longer pain relief. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Pain pump vs. Exparel. Is one medication actually better or just less of a hassle because you don't have to wear the pump?

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Thank you for the question. Good pain control after tummy tuck is very important for many reasons.  Besides the important concern of patient comfort, good pain control allows for better/easier deep breathing exercises and ambulation.  These measures may lead to decreased incidences of pulmonary complications and/or thromboembolic phenomenon.

These days plastic surgeons have many options when it comes to pain control after tummy tuck surgery. The use of narcotic medication, muscle relaxants, non-narcotics, pain control pumps, and long-lasting local anesthetics have made the postoperative experience much better than in the past.  In our practice, all patients undergoing, tummy tuck surgery receive a postoperative pain control pump.  I have yet to have a patient complain of the "hassle" factor. In my opinion, there is no demonstrable difference between the use of local anesthesia provided through a pain pump versus long lasting injectable anesthetics. There are certainly no objective studies that demonstrate the superiority of one over the other. Best wishes.

Pain pump vs Exparel

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I have used both in my practice but have switched exclusively to using Exparel.  While I don't have any study or evidence that either is more effective, my impression is that Exparel is equally as effective and considerably easier to use as there is no external device to maintain.  Based on what the hospital charges for a pain pump vs the cost of Exparel, I have found them to be similar in cost.  I'm glad that you are considering these options as both help to decrease your postop pain.  Best of luck with your surgery!

Jeffrey A. Sweat, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 51 reviews

Pain pump vs. Exparel

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My impression is that Exparel and the pain pump are similar in addressing post op pain--both use bipuvacaine as the anesthetic agent. I am unaware of any study that compares the two, however. Some patients complain about the hassle of wearing the pump, others are ok with it. Exparel does not have that hassle factor but is considerably more expensive than the pump.

Postoperative Pain Reduction/prevention.

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Thank you for your question.
I am unaware of a scientific study comparing the two.
Exparel is along acting injectable Bupivacaine .
Price difference is significant.
Both can be injected locally.
A pain pump us a mechanical device where there is a external "pump" through which thin catheters are inserted into the surgical site. For the next several days the local anesthestic agent (usually Bupivacaine) is release at constant flow. Thin catheters need to be removed in 3-4 days .
Contrasting the two:
1)one time local injection
2) works only where injected
3)longer 1/2 life of Bupivacaine (effects last longer)
Non narcotic pain pump 
1) a external delivery system through small catheters 
2) can diffuse throughout the surgical site: in breast augmentation or abdominoplasty the anesthestic (Marcaine) fluid can disperse throughout the entire surgical pocket and theoretically cover more area  in contrast to direct injection of the Exaparel or Bupivacaine in certain ares thus is only effective where locally injected.
3) Some pumps have a "on demand" function where additional local anesthetic volume can be intermittently delivered (with a corresponding lock out period so as not overdose).

I personally perfer the pain pump for long term pain relief (3-4 days) and  perform local injection of local anesthestic on almost every surgical case. I provide a pain pump to all my abdominaloplasty patients. The pain pump is optional for all other procedures.

Please make a appointment with a experienced Plastic Surgeon who is Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
My best wishes,

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.