Pain Killer Offers Cost Savings, Patient Comfort

In a study of 2, 248 hip and knee replacement patients, those treated with the pain killer Exparel (bupivacaine liposome injectable suspension) reported significantly lower pain scores. According to the manufacturer, Pacira Pharmaceuticals, Inc., in a presentation at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS), patients treated with Exparel were more likely to report having “zero pain” during their hospital stay and were associated with lower hospital costs.

More than 1.1 million joint replacements are performed annually in the U.S. and post surgical pain is usually managed with regional nerve blocks and systemic opioids. In this study half of the patients received periarticular injections (PAI) with bupivacaine HCl, with or without ketorolac, and morphine, while the other half received PAI with Exparel.

The primary outcomes measured were Visual Analog Scale (VAS) pain scores and the percent of VAS pain scores that were zero, meaning patients reported “no pain.” In addition researchers compared length of stay, patient-reported satisfaction and per patient costs for supplies and pharmaceuticals between the two treatment groups.

The researchers found average cost savings of $1, 246 per patient, which resulted in an overall hospital savings of over $1.5 million, predominately attributed to eliminating the need for femoral nerve catheters, knee immobilizers, and patient controlled analgesia pumps to deliver IV opioids.

John Barrington, M.D., orthopedic surgeon at Texas Center for Joint Replacement in Plano, Texas, said, “Getting patients on their feet and moving is critical to optimizing long-term treatment outcomes after hip or knee surgery, and the ability to provide a single-dose long-lasting alternative to opioids and catheter-based regional nerve blocks—which can negatively impact ambulation and the patient recovery experience—is a major advantage for orthopedic patients. Our analysis found that the use of Exparel can improve both pain control and patient satisfaction, while resulting in a meaningful cost savings per patient.”