Board certified oral & maxillofacial surgeon Dr. Leslie Sultan was recently selected as one of 50 practices nationwide to participate in an early evaluation of EXPAREL™. EXPAREL™ is a new ultra-long acting, non-narcotic local anesthetic administered during oral surgical procedures to reduce postoperative pain levels and the potential need for narcotic usage.
EXPAREL™ is a non-narcotic local analgesic. It is administered during your procedure directly into the surgical site. A single application of EXPAREL™ is long lasting, so your doctor doesn’t need to use catheters or other devices to extend your pain control.
EXPAREL™ is also proven to help patients use fewer narcotics as they start their recovery.
Just like the dentist numbs your mouth when you get a filling, surgeons use EXPAREL™ to numb the area on your body where your surgery is performed. EXPAREL™ is specially formulated to slowly release a proven ingredient—called bupivacaine—over time. This slow release makes it possible for EXPAREL™ to control pain after surgery and potentially decrease your need for narcotic medication with just a single dose.
For more information visit exparel.com
“A non-Narcotic Management of Pain Control”
Unfortunately, almost every invasive procedure has some degree of post-operative pain and/or discomfort. Depending on the nature of the procedure and the training and experience of the surgeon, various pain control medications are utilized to minimize symptoms and enhance patient comfort.
For mild to moderate discomfort, your surgeon may recommend over the counter analgesics and/or anti-inflammatory medications. They act both in the central nervous system or at the site of the procedure. They are considered relatively safe and are non-addictive.
For severe pain, traditional methods of pain control have included the use of opiates/narcotics. These medications act centrally, or within the brain to provide pain control. They also cause sedation, anesthesia, and euphoria. As such, they can become highly addictive if not used properly.
Although narcotics will always be a part of severe postoperative pain control, evidence-based opioid-free protocols have been evaluated to minimize or eliminate their use. Dr. Sultan is highly trained in the use of all forms of sedation and anesthesia, including postoperative pain control. He was one of the first 50 oral & maxillofacial surgeons in the US to utilize and to become a clinical consultant for the use of ultra-long acting local anesthesia.
For those patients who have indications, Dr. Sultan will recommend a multi-modal non-narcotic pain management protocol, including medications attacking pain from multiple directions:
- Long-acting local anesthesia (bupivacaine/Marcaine®) - when injected at the surgical site, reduces nerve cell transmission of pain impulses for 6-8 hour.
- Analgesics (acetaminophen/Tylenol®) - acts on the central nervous system to reduce pain modulating enzymes and fever. It has little to no anti-inflammatory effect.
- Non-steroidal anti-inflammatories (ibuprofen/Advil®) - works peripherally at the site of surgery to reduce pain modulating enzymes but also reduces fever and inflammation/swelling.
- Neural pain modulators (Neurontin/Gabapentin®)- used to minimize neuropathic pain and recently shown, when given prophylactically to reduce postoperative nerve impulses.
- Ultra-long acting local anesthesia (Exparel®) – this novel medication has been developed to deliver long-lasting post-operative pain at the surgical site. It is a proprietary formulation of bupivacaine, that when injected at the surgical site, can provide 48-72 hours of pain control in most patients.
When used in our recommended protocol, all these medications act synergistically, or in combination with each other, to provide longlasting pain relief without the need for narcotics.
Dr. Sultan will discuss his recommendations for pain management at your consultation visit with the best options in your specific situation.