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Exparel


At DFW Oral Surgeons, we offer a safe and effective alternative to prescription narcotics that reduces or even eliminates your pain following a surgical procedure. The medication is called Exparel, and it is slowly revolutionizing pain management. The use of Exparel during your oral surgery can help you avoid the potentially harmful side-effects of narcotics, mainly opioids.

Facts About Exparel


•  Exparel works by numbing the area of your body where your surgery was performed, unlike opioids, which affect your whole body
•  Exparel keeps the surgical area numb for a total of THREE days.
•  Exparel is not a narcotic medication
•  Exparel gives long-lasting pain control, meaning you may need fewer pain medications

What Is Exparel?


Exparel is the brand name for a medication known as bupivacaine liposome, a local injectable anesthetic that numbs the surgical site. Unlike other local anesthetics, however, Exparel remains effective for a total of three days! Keeping your surgical site numb for three days provides long-lasting pain control, which reduces or eliminates the need for opioids.

It is important to note that we can only use Exparel for patients over the age of 18. During your initial consultation, John C. Shillingburg, DDS will review your medical and dental history to determine if the medication is right for you. Patients that are pregnant or suffer from severe hepatic disease will not qualify for the use of Exparel.

Once administered, the medication will numb the area around the surgical site almost instantly. Exparel works by blocking the nerve receptors responsible for pain, producing surgical and postsurgical local analgesia for an average of 72 hours. Side-effects are rare, but they can occur. 10% or less of patients report adverse effects, such as nausea, constipation, and vomiting.

Reason We Recommend Exparel


There are several reasons to consider a non-narcotic alternative to opioids. Above all else, narcotics can lead to substance abuse problems and addiction, with one in 15 patients becoming a longer-term narcotic user. This has led to a nationwide call to reduce opioid use.

Pain management with Exparel also has less impact on your daily activity. One in seven people experiences side-effects after taking narcotics, with 92% of postsurgical patients reporting adverse reactions to opioids. Ultimately, this can delay your return to work.

Again, Exparel can help you reduce or eliminate your consumption of opioids following oral surgery. The first few days following surgery are typically the most uncomfortable. Keeping the surgical site numb for upwards of three days results in less overall pain for you. This is a revolutionary new method that has the potential to benefit millions of people and stifle the opioid epidemic!

Recovery with Exparel


Once your surgery is complete, John C. Shillingburg, DDS will give you a detailed set of post-operative instructions before you leave our office. Follow these instructions closely to reduce your risk of post-operative complications. If you do experience any significant issues in the days or weeks following your procedure, be sure to contact us as soon as possible.

As dentalcare professionals, we are constantly searching for new ways to provide our patients with a supreme level of care. Our use of Exparel will keep your pain under control, allowing you and your body to better focus on the healing process. Studies have shown that Exparel results in nearly 14% less pain, with a 78% reduction in opioid consumption. You, too, could benefit from the use of Exparel following your oral surgery.

Schedule Your Consultation Appointment


If you want the very best treatments modern oral surgery has to offer, you have come to the right place! Call (972) 539-1491 to schedule your consultation today!

Important Notice


This site is for informational purposes only and is intended to address medical questions from healthcare professionals in the United States.

To report an adverse event, email drugsafety@pacira.com or call 1-855-RX-EXPAREL (793-9727).

For medical inquiries related to EXPAREL, submit a request to Medical Information or call 1-855-RX-EXPAREL (793-9727).

These are not all of the potential important safety considerations for EXPAREL; please see the full Prescribing Information.

References



  1. Data on File. 5499. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; February 2019.

  2. Patel M, Gadsden J, Bao X, Bendtsen T. Brachial plexus block with liposomal bupivacaine for total shoulder arthroplasty or rotator cuff repair: results from a randomized controlled trial.
  3. Poster presented at: The New York School of Regional Anesthesia 16th Annual Fall Symposium; September 23-24, 2017; New York, NY.
  4. Data on File. 4513. Parsippany, NJ: Pacira Pharmaceuticals, Inc.; March 2018.

  5. Mont MA, Beaver WB, Dysart SH, Barrington JW, Del Gaizo DJ. Local infiltration analgesia with liposomal bupivacaine improves pain scores and reduces opioid use after total knee arthroplasty: results of a randomized controlled trial. J Arthroplasty. 2018;33(1):90-96.

  6. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012;116(2):248-273.

  7. Kessler ER, Shah M, Gruschkus SK, Raju A. Cost and quality implications of opioid-based postsurgical pain control using administrative claims data from a large health system: opioid-related adverse events and their impact on clinical and economic outcomes. Pharmacotherapy. 2013;33(4):383-391.


Indication


EXPAREL is indicated for single-dose infiltration in adults to produce postsurgical local analgesia and 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 is contraindicated in obstetrical paracervical block anesthesia

  • Adverse reactions reported with an incidence greater than or equal to 10% following EXPAREL administration via infiltration were nausea, constipation, and vomiting; adverse reactions reported with an incidence greater than or equal to 10% following EXPAREL administration via interscalene brachial plexus nerve block were nausea, pyrexia, and constipation

  • If EXPAREL and other non-bupivacaine local anesthetics, including lidocaine, are administered at the same site, there may be an immediate release of bupivacaine from EXPAREL. Therefore, EXPAREL may be administered to the same site 20 minutes after injecting lidocaine

  • EXPAREL is not recommended to be used in the following patient population: patients < 18 years old and/or pregnant patients

  • Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease


Warnings and Precautions Specific to EXPAREL



  • Avoid additional use of local anesthetics within 96 hours following administration of EXPAREL

  • EXPAREL is not recommended for the following types or routes of administration: epidural, intrathecal, regional nerve blocks other than interscalene brachial plexus nerve block, or intravascular or intra-articular use

  • The potential sensory and/or motor loss with EXPAREL is temporary and varies in degree and duration depending on the site of injection and dosage administered and may last for up to 5 days, as seen in clinical trials


Warnings and Precautions for Bupivacaine-Containing Products



  • Central Nervous System (CNS) Reactions: There have been reports of adverse neurologic reactions with the use of local anesthetics. These include persistent anesthesia and paresthesia. CNS reactions are characterized by excitation and/or depression

  • Cardiovascular System Reactions: Toxic blood concentrations depress cardiac conductivity and excitability which may lead to dysrhythmias, sometimes leading to death

  • Allergic Reactions: Allergic-type reactions (eg, anaphylaxis and angioedema) are rare and may occur as a result of hypersensitivity to the local anesthetic or to other formulation ingredients

  • Chondrolysis: There have been reports of chondrolysis (mostly in the shoulder joint) following intra-articular infusion of local anesthetics, which is an unapproved use

  • Methemoglobinemia: Cases of methemoglobinemia have been reported with local anesthetic use


Please refer to full Prescribing Information.

Our Office


is located in a beautiful new building right off of Long Prairie Road in Flower Mound, TX. With close parking and easy accessibility.
Contact John C. Shillingburg, DDS, at our Flower Mound, TX 75028-1795 location. We are here for you. (972) 539-1491
DFW Oral Surgeons building front in Flower Mound, TX
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