By Daniel W. Todd, MD, FACS
EXPAREL, a proprietary product from Pacira Pharmaceuticals, is a novel long-acting, sustained-release formulation of bupivacaine, a local anesthetic widely used for treating postoperative pain. EXPAREL is being studied in several different types of surgical procedures where postoperative pain management is especially problematic and where the need for prolonged analgesia with a single intraoperative administration can provide a significant improvement in pain relief — especially during the first 72-hours following surgery — while also minimizing the need for opioids. With improved prolonged postoperative pain management and a reduction in opioid consumption, Pacira believes patients treated with EXPAREL will experience better pain management and have fewer opioid-related side effects such as nausea and vomiting, and improved outcomes overall.I have now used it in adult tonsillectomy and UP3 patients with pleasant results. I have found 6-8cc works well and there is no need to dilute it.