Why is Exparel or similar long lasting anesthesia not available for tummy tucks in Canada?

Question

So many tummy tuck surgeons in the US say this drug has been a tremendous advancement for pain management, reducing DVTs and narcotics use. If this is the case why has Canada not approved this?

Jerome Edelstein, MD · Answer

Hello,Thank you for your question. This is a good question. The similar long-acting option that we have in Canada is Marcaine which I use during abdominoplasty to keep patients comfortable for at least 12 hours post op. This helps to bypass significant pain in the early post-op phase and allows patients to be more mobile and independent. Exparel is known to last for at least twice as long and carries a higher price tag. This method of analgesic can help to reduce or completely negate the use of oral narcotic pain medication after surgery and makes recovery more pleasant. I have reduced the amount of discomfort and post-procedure pain medication considerably using Marcaine in my practice and will certainly be interested in the longer acting option when it is available here.All the best

Marc DuPéré, MD · Answer

Thank you for your question.  I "feel your pain", pun intended.  I am also hoping to have it for my patients.  Yet, there is a regulatory process at Health Canada that decides on the medications available in Canada.  They evaluate safety and research studies.  That process takes times and we are a smaller county.That being said, marcaine does exist in Canada, just not the longer-lasting marcaine (called exparel).  I used it every day in my clinic and I do inject the rectus muscle and fascia during my tummy tuck procedures, giving 8-12 hours of pain-relief, enough to bring my patients in the "comfort zone" in pain management post tummy tuck surgery.I also keep most of my tummy tuck patients overnight in our accredited facility, with 2 nurses, so the pain requirements will be met and a more comfortable night is provided.I will be the first one to use Exparel when available.Kind regards,Dr. Marc DuPere, aesthetic plastic surgeon.

Why is Exparel or similar long lasting anesthesia not available for tummy tucks in Canada?

Answers (2)

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