Revolutionizing the Oral Surgery Recovery Experience with Non-Opioid Options

Why Our Practice Started Offering an Opioid Alternative for Pain Management
9:55 AM, Jun 02, 2022

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Many patients consider dental procedures to be particularly uncomfortable, and often dread the pain and discomfort associated with them. When it comes to procedures such as wisdom tooth extractions, I’ve found that a primary concern for many of my patients leading up to surgery is how their pain will be managed afterward. As an oral and maxillofacial surgeon, I’ve made it my mission to find ways to effectively manage pain before, during, and after surgery while enhancing my patients’ overall recovery experience.

Over the last couple decades, opioids have become a common pain management tool for a variety of procedures, including oral surgeries. Subsequently, providers have started to fully understand and witness the negative effects of them. Even if taken as prescribed, opioids are associated with a variety of side effects such as constipation, drowsiness, nausea, confusion, and the risk for addiction or dependence. Armed with this information, I’ve made a conscious effort to educate myself and my patients about non-opioid options that can help manage pain after surgery while reducing, or even eliminating, the need for an opioid prescription.

Incorporating Non-Opioid Options into Our Practice

At Eastern Virginia Oral & Maxillofacial Surgery, we have incorporated a non-opioid option called EXPAREL® (bupivacaine liposome injectable suspension) into our pain management protocol for wisdom tooth extractions and other oral and maxillofacial surgeries. EXPAREL is a long-acting numbing medication that is injected into the surgical site by Dr. Conelias or myself during the procedure to help alleviate pain after surgery. This option slowly delivers a numbing medication over time into the area where it is injected; therefore, patients can experience pain relief for the first few days after surgery, when pain is typically at its worst. As the first oral surgery clinic in the Hampton Roads area offering this

option, we have been fortunate enough to see patients across the region who have experienced an enhanced recovery with limited opioid use because of this pain management protocol.

Improving Patients’ Recovery Experience

Incorporating EXPAREL into our multimodal pain management protocol, which includes a range of non-opioid options like acetaminophen and ibuprofen, has benefited our patients’ overall recovery experience. One of the most rewarding outcomes for both myself and my patients is that I have been able to effectively reduce the number of opioids I prescribe.

EXPAREL is also the first and only FDA-approved long-lasting non-opioid pain management medication approved for use in patients ages six and above. This is meaningful since we know that younger patients are often first exposed to an opioid prescription following dental procedures. As a population with a particular risk for long-term issues such as dependence or addiction, having a non-opioid option is especially critical.

Advocating for Alternative Options With drug overdose deaths on the rise again nationally, and an average of four Virginians dying of an opioid overdose every day, it is imperative that patients feel empowered to ask their providers about their personal pain management plan and how they can incorporate non-opioid options. Conversations about pain management and the recovery process should happen prior to a patient’s procedure and I strongly urge patients to bring it up at their initial consultation.

Patients have a choice when it comes to how their pain will be managed after surgery. In light of the opioid epidemic, it is important that patients and providers work together to have informed conversations about pain management strategies, including non-opioid options like EXPAREL that can help provide an enhanced recovery experience after surgery.

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This article is sponsored by Pacira BioSciences, Inc.


EXPAREL® (bupivacaine liposome injectable suspension) is indicated for single-dose infiltration in patients aged 6 years and older to produce postsurgical local analgesia and in adults 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 should not be used in obstetrical paracervical block anesthesia.

In studies in adults where EXPAREL was injected into a wound, the most common side effects were nausea, constipation, and vomiting.

In studies in adults where EXPAREL was injected near a nerve, the most common side effects were nausea, fever, and constipation.

In the study where EXPAREL was given to children, the most common side effects were nausea, vomiting, constipation, low blood pressure, low number of red blood cells, muscle twitching, blurred vision, itching, and rapid heartbeat.

EXPAREL can cause a temporary loss of feeling and/or loss of muscle movement. How much and how long the loss of feeling and/or muscle movement depends on where and how much of EXPAREL was injected and may last for up to 5 days.

EXPAREL is not recommended to be used in patients younger than 6 years old for injection into the wound, for patients younger than 18 years old for injection near a nerve, and/or in pregnant women.

Tell your health care provider if you or your child has liver disease, since this may affect how the active ingredient (bupivacaine) in EXPAREL is eliminated from the body.

EXPAREL should not be injected into the spine, joints, or veins.

The active ingredient in EXPAREL can affect the nervous system and the cardiovascular system; may cause an allergic reaction; may cause damage if injected into the joints; and can cause a rare blood disorder.