Outpatient Surgery Magazine

Manager's Guide to Surgery's Ambulatory Anesthesia - July 2015

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 15 of 68

1 6 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E J U LY 2 0 1 5 Exparel study patients likely received additional pain medication, while Exparel patients received nothing more. Dr. Onel also says pain studies don't always measure such key benchmarks as patient satisfaction, opioid usage and discharge time. "When you look at the studies that have shown Exparel led to a decrease in discharge, the question becomes: Will you spend a couple hundred dollars to save a couple thousand dollars?" says Dr. Onel. An anesthesiologist who was involved with the earlier studies agrees in part. He says, "I think the drug probably performs better than some of the trials sug- gest." Another theory has it that Exparel's showing in studies might relate to how precisely you must infiltrate it. Exparel's high-tech designer drug delivery mole- cule, which encloses bupivacaine in the vesicles of an artificial glob of fat so that the medication will trickle out over time rather than being flushed by the circulatory system, makes it highly dependent on how it's injected. It doesn't dif- fuse, so it works best when it's infiltrated into the surgical wound in a very spe- cific manner. "Technique is critical," says orthopedic surgeon Thomas Meade, MD, of Allentown, Pa. "If it's not done correctly, the results are not that good. You have to think like a sniper, not a shotgun." OSM E-mail doconnor@outpatientsurgery.net.

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