Local anesthetic is a type of medication that helps control your pain after surgery so you can have a better recovery. It works by numbing the area where it is administered. It is different from an opiod or other pain pills. We offer two methods of prolonged delivery of local anesthetic as options for your procedure. Both methods are available at a similar additional fee, but each has unique benefits.
The ON-Q* Pain Pump is a small disposable pump filled with Marcaine (numbing medicine) to relieve your pain after surgery. An On-Q* Pain Pump delivers a continuous flow of Marcaine at a very slow flow rate. The pump is connected to two tiny, IV-sized catheters (tubes), which are inserted during surgery. A single Marcaine injection last 3 – 5 hours but a steady flow can be delivered via the pump for 3 – 4 days following surgery. The pump is about the size of a large lemon and is completely portable; it may be clipped to your clothing or placed in a small belt “pouch”.
EXPAREL® is a recently introduced local anesthetic developed to last for days with a single treatment. During a procedure, the doctor injects EXPAREL® throughout the surgical area. EXPAREL® contains specially formulated bupivacaine (a type of local anesthetic) that is designed to release in the surgical area over a long period of time for prolonged pain relief. One advantage is that there is no need for an external pain pump to manage following surgery; Exparel® does not require any tubes or devices, therefore the use of Exparel® will avoid the need for an external pump to deliver local anesthetic. The trade-off appears to be that the Exparel® option may last closer to three days, compared to four days for the On-Q* Pain Pump (this requires a onetime refill after two days).
Exparel® comes in a single dose bottle and is comparable to the cost of an On-Q* Pain Pump and the Marcaine local anesthetic used. Both are available as options to help in your recovery. Neither provides an absolute guarantee in terms of exact percentage or duration of pain control, but 3 – 4 days’ duration is typically noted and from our observation the improvement in post-op pain with both is very significant. In the majority of patients, the use of narcotics is greatly reduced and getting up to ambulate after surgery appears to be helped tremendously. During your consultation we can discuss both options to help decide which might be best for you.