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Clinicians Adopt Team-based Approach to Transform Patient Pain Management Experience After Surgery

According to The University of Texas Health Science Center School of Biomedical Informatics, Houston sees one opioid-related death every 32 hours.

Presented by Pacira BioSciences, Inc. By Dr. Stefan Kreuzer and Dr. Chauncey Jones July 23, 2021

According to The University of Texas Health Science Center School of Biomedical Informatics, Houston sees one opioid-related death every 32 hours. And, despite national efforts to end America’s opioid crisis, research suggests that patients continue to receive large amounts of opioids to manage pain after surgeries like knee and hip replacements, rotator cuff repairs, etc. As healthcare providers, we have an opportunity to bring innovative pain management solutions to our patients that can help reduce or, in some cases, eliminate the need for opioids after surgery therefore decreasing the number of pills flooding into our community.

At INOV8 Surgical in Houston, we approach all total joint procedures with a strategic, team-based mentality that includes nurses, anesthesiologists, surgeons, and recovery teams who are trained on our non-opioid approach to ensure there is a streamlined care path for each patient. Each patient also receives preoperative education and extensive follow-up to ensure their surgical experience is as positive as possible. 

A key ingredient to our multimodal pain management approach is a non-opioid option called EXPAREL® (bupivacaine liposome injectable suspension). EXPAREL is a long-acting local anesthetic that is injected into the surgical site during the procedure to provide pain relief for the first few days when pain is often at its worst. This is imperative, as managing the 24-48 hours after surgery are critical in helping to decrease rebound pain or potential readmission. Because of its effectiveness, we now use EXPAREL in all total joint procedures, which has reduced our average length of stay and sends our patients home the same day. In fact, we have performed over 800 same-day discharge total joint procedures since implementing this multimodal approach and it has been instrumental in improving our patients’ recovery experience.  

By staying up to speed on the latest treatment options and ensuring all clinicians along the care continuum are educated on this non-opioid-based approach, we have been able to provide patients with well-managed pain and a positive overall recovery experience with little-to-no opioid exposure. We look forward to continuing to provide our patients with innovative methods that advance their care.

For more information, please visit www.EXPAREL.com/safety.


EXPAREL® (bupivacaine liposome injectable suspension) is indicated for single-dose infiltration in patients aged 6 years and older to produce postsurgical local analgesia and in adults as an interscalene brachial plexus nerve block to produce postsurgical regional analgesia. Safety and efficacy have not been established in other nerve blocks.

Important Safety Information

EXPAREL should not be used in obstetrical paracervical block anesthesia.

In studies in adults where EXPAREL was injected into a wound, the most common side effects were nausea, constipation, and vomiting.

In studies in adults where EXPAREL was injected near a nerve, the most common side effects were nausea, fever, and constipation.

In the study where EXPAREL was given to children, the most common side effects were nausea, vomiting, constipation, low blood pressure, low number of red blood cells, muscle twitching, blurred vision, itching, and rapid heartbeat.

EXPAREL can cause a temporary loss of feeling and/or loss of muscle movement. How much and how long the loss of feeling and/or muscle movement depends on where and how much of EXPAREL was injected and may last for up to 5 days.

EXPAREL is not recommended to be used in patients younger than 6 years old for injection into the wound, for patients younger than 18 years old for injection near a nerve, and/or in pregnant women.

Tell your health care provider if you or your child has liver disease, since this may affect how the active ingredient (bupivacaine) in EXPAREL is eliminated from the body.

EXPAREL should not be injected into the spine, joints, or veins.

The active ingredient in EXPAREL can affect the nervous system and the cardiovascular system; may cause an allergic reaction; may cause damage if injected into the joints; and can cause a rare blood disorder.