Surgeon finds EXPAREL analgesic can reduce opioid use


Dr. Brian Badman was looking for a way to alleviate patients’ pain without opioids.

Badman, an orthopedic surgeon, has a 100 percent elective shoulder surgery practice, conducting surgeries as simple as rotator cuff repairs to complicated shoulder replacements.

CIC HEALTH 1124 Dr Badman

“Pain management after any of those procedures, patients are often told it is the worst experience they are ever going to go through,” said Badman, a Zionsville resident who has main offices in Carmel and Avon. “So, anything we can do as surgeons to help mitigate pain and hopefully make their experience better is always a good thing. With the opioid crisis, we’re trying to get people away from that.”

Badman said he started using EXPAREL, a long-acting numbing medication that is injected into the surgical site during surgery, more than two years ago.

“When it was first released, the indication for surgeons is you could inject around the soft tissue after surgery,” he said. “It helped. It wasn’t perfect. They got FDA clearance to start using it in blocks. When I do shoulder surgery, my anesthesia colleagues will do a nerve block.”

EXPAREL gives a patient approximately 72 hours of pain relief, Badman said.

“We started using that for rotator cuff patients to give them more pain management after surgery,” Badman said.

Badman said he did a study, which will be published in an orthopedic journal this month, to prove effectiveness by looking at the differences in patients’ pain and how many pain pills were taken after surgery.

“We found a significant reduction in those patients undergoing rotator cuff surgery with the EXPAREL block as compared to those who got a regular block,” he said. “If you got an EXPAREL block, you on average took nine fewer pain pills for the first four days after surgery. When you see it, you might think nine pain pills is not a lot. But nine pain pills, in the grand scheme of things, translates to two days less of a patient taking narcotics.”

Badman said research shows if a patient takes narcotics longer than eight days, there is a 15 percent chance they are going to be on long-term narcotics after one year. Badman finished the study in January.

“We, as physicians, partially created this problem that we are seeing as far as people becoming addicted,” Badman said. “I don’t like to dispense narcotics more than a week’s worth.”

EXPAREL can be used for surgeries ranging from wisdom tooth extraction and other dental surgeries, C-section deliveries, hysterectomies, bariatric surgeries, plastic surgeries, breast reconstruction and orthopedic surgeries.

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