Today, patients should expect more after surgery and feel empowered to ask—on behalf of themselves or their loved ones—about their options to manage pain. There are effective non-opioid options that can represent an X-factor for an enhanced recovery experience following surgery

Prehab to Rehab Steps for Success

A pain management plan should be tailored to your needs and include options to manage pain from prehabilitation (before surgery) to rehabilitation (after surgery)

Prehab (before surgery)

  • Prehab is participation in therapy-based treatments to reduce injury, decrease pain, or to prepare for a surgery
  • Prehab programs aim to improve physical fitness and function before surgery that could lead to enhanced recovery and better outcomes after surgery1
  • It is generally recommended to engage in prehab approximately 2 months prior to a surgery2
  • When done correctly, prehab can decrease the time and pain associated with postsurgical recovery3
  • If you’re experiencing pain, your doctor may recommend treatment options to help alleviate pain prior to surgery, such as ice, over-the-counter medications (eg, acetaminophen, ibuprofen, etc.), non-drug interventions (eg, acupuncture, meditation, massage therapy, or cryoanalgesia like iovera°)
    • iovera° is a novel, FDA-cleared non-opioid treatment that allows health care providers to control pain by delivering extreme cold therapy to the targeted nerve
    • The iovera° treatment uses the body’s natural response to cold to treat nerves and immediately reduce pain. Treated nerves are stopped from sending pain signals for a period of time, followed by a restoration of function. Results can be felt immediately after treatment and can last for 90 days, as the nerve regenerates over time4

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The iovera° system is used to destroy tissue during surgical procedures by applying freezing cold. It can also be used to produce lesions in peripheral nervous tissue by the application of cold to the selected site for the blocking of pain. It is also indicated for the relief of pain and symptoms associated with osteoarthritis of the knee for up to 90 days.

During Surgery

  • The best way to reduce opioid exposure is for your clinician to use a “multimodal” pain management approach, meaning that multiple types of pain medication are used in the smallest effective doses to provide effective pain control with minimal side effects and minimal reliance on opioids
  • There are many different combinations of non-opioid treatments that make up a multimodal plan, including intravenous (IV) acetaminophen, non-steroidal anti-inflammatories (NSAIDs) such as naproxen or ibuprofen, local anesthetics, gabapentin, etc
  • EXPAREL® (bupivacaine liposome injectable suspension), when combined with other non-opioid options, can represent an X-Factor in surgical recovery
  • This long-acting, non-opioid is injected during surgery numbing the part of the body where surgery was performed—unlike opioids, which affect your whole body
  • EXPAREL starts controlling pain during surgery and continues for the first few days after surgery, when patients need it the most
  • EXPAREL is proven in clinical trials to reduce the need for opioids*
    • EXPAREL patients went longer before needing opioids than those who didn’t receive EXPAREL
    • EXPAREL patients required fewer opioids than those who didn’t receive EXPAREL
  • EXPAREL can provide relief after all kinds of surgeries, including:

*The clinical benefit of the decrease in opioid consumption was not demonstrated in the pivotal trials

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EXPAREL is indicated for single-dose infiltration in adults to produce postsurgical local analgesia and as an interscalene brachial plexus nerve block to produce postsurgical regional analgesia. Safety and efficacy have not been established in other nerve blocks.

Rehab (after surgery)

  • After surgery, rehab can help you regain your strength and improve the way you move the part of your body where you had your surgery6
  • Rehab can speed your recovery no matter what kind of operation you’ve had6
  • If your surgery requires you to stay overnight in the hospital, rehab will likely start with a therapist who will help you get out of bed and start to walk again. This is also known as ambulation
  • Depending on the surgery you had, rehab might be inpatient, meaning you’ll stay at a recovery center, or outpatient, which means you live at home, but get therapy during regular appointments throughout the week
  • If you followed a prehab plan, your overall rehab experience might be speedier. In fact, people going through prehab before knee and hip replacement surgeries were 73% less likely to need to have inpatient rehab after their surgery8
  • It’s important to remember that rehab can be a long process as your body works to regain strength following surgery. Work with your team of doctors, physical therapists, and caregivers to ensure you’re following a plan that will help you get stronger each day

Have a Discussion

  • While certain non-opioid pain treatments have fewer side effects and can reduce hospital stays, the vast majority (74%) of women do not discuss those options with their surgeon before their procedure5
  • When patients were asked why they didn’t discuss non-opioids with their doctor prior to surgery, more than half (54%) said that they trust their doctor’s recommendations5
  • Talk to your doctor to create the most appropriate surgical pain management plan for you