Planning a total knee replacement?
Questions to ask your doctor about pain management
A Total Knee Replacement (TKR) is one of the most
commonly performed orthopedic procedures. In fact, the
number of TKRs performed annually in the United States
is expected to grow exponentially to 1.5 million additional
procedures by 2030.
If you are currently talking to your doctor about a TKR,
you may have questions about pain management. It is one
of the concerns for patients who are considering a TKR.
In the U.S., 99 percent of surgical patients are prescribed
post-surgical opioids, but they may not always
be the best choice for everyone. Some patients hesitate
because they are worried about the side effects of opioids,
such as nausea and drowsiness, that may keep them off
their feet and disrupt their daily life for an extended period
of time.
Others worry about addiction. A recent study found
that 53 percent of knee-replacement patients were still
taking opioids six months after surgery, with a higher
incidence among those who also took opioids for pain
management in advance of surgery for their chronic pain.
Thanks to recent advances in pain management, there
are non-opioid options to manage pain effectively. One
option is EXPAREL® (bupivacaine liposome injectable
suspension), a long-lasting local analgesic targeted at the surgical
site.
EXPAREL is not a pill; it goes to work directly at the surgical site
via an injection administered by a surgeon, and numbs the pain in
the area on your body where surgery was performed. It is non-opioid
and is not addictive.
Some might wonder whether a non-opioid option could manage
pain as efficiently, or for as long. A recent study published in The
Journal of Arthroplasty found a 78 percent decrease in opioid consumption
and significant reduction in pain scores with the use of
EXPAREL. Ten percent of patients required no opioids for pain control
post-surgery.
If you are considering a TKR, there are a few things about pain
management you will want to keep in mind. Pain management after
surgery has a significant impact on recovery. The best way to prepare
is to talk to your doctor about your concerns and preferences during
your consultation.
Pain is a personal experience and an informed conversation with
your doctor may lead to better post-surgical outcomes related to
pain. You should also be clear about how you may want to manage
your post-surgical pain, whether opioid or non-opioid based.
Here are some questions to consider as you prepare to speak to
your doctor about a pain management plan:
1. How much discomfort is usually associated with this procedure?
Some pain after surgery is normal but everyone’s experience is
different. Ask your doctor to explain how pain progresses and subsides
with a typical TKR. It is also important to understand how you
are personally managing pain now and the impact that will have on
your recovery.
2. What can I expect in the first few days after my procedure? It’s
important to talk to your doctor, who can help you understand how
long it might take to get back to doing the things you love. EXPAREL
works directly at the surgical site - unlike opioids, which affect the
whole body.
3. How will my pain management plan be impacted by other medications?
Be sure to share your entire medical history with your doctor
in advance of a TKR. This includes all medications, both prescription
and over the counter, that you take regularly in advance of your
TKR. Being clear about the type of pain management treatments you
are taking now can help inform your doctor’s plans for pain relief
post-surgery.
4. What are the signs or symptoms that I need to adjust my pain
management plan? Everyone responds to pain differently. Communicate
with your healthcare team to help make your recovery as pain
free as possible. You also should have a clear pain management plan
and milestones for adjusting your pain relief medications.
5. Am I a good candidate for EXPAREL? Your pain management
program should be personal. If you are interested in a non-opioid
treatment option administered during surgery be sure to ask your
doctor. Your doctor can advise if you are a good candidate and work
it into your treatment plan, if appropriate.
Create an open dialogue with your doctor in advance of your TKR.
Your pain management is your decision. (BPT)
EXPAREL is indicated for administration into the surgical site to
produce post-surgical analgesia.
Important Safety Information
EXPAREL should not be used in obstetrical paracervical block
anesthesia.
In studies with EXPAREL, the most common side effects were
nausea, constipation and vomiting.
EXPAREL is not recommended for use in patients younger than 18
years of age or in pregnant women.
Tell your healthcare professional if you have liver disease as this
may affect how the active ingredient (bupivacaine) in EXPAREL is
eliminated from your body.
EXPAREL should not be injected into the spine, joints or veins.
Other local anesthetics should not be injected immediately after
injecting EXPAREL; this may lead to an immediate release of the
active ingredient in EXPAREL.
The active ingredient in EXPAREL can affect your nervous and
cardiovascular system, may cause an allergic reaction, and/or if injected
into your joints may cause damage to the joints.
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