Local doctor does N.J.'s 1st, 2nd opioid-sparing surgery

New nerve block controls pain for 48-72 hours to cut opioid need
Just 6 days ago, the Food & Drug Administration approved a new use for Exparel, a pain-blocker, enabling it to be used closer to the nerve in shoulder surgery, reducing the need for opioids.

Dr. Sean McMillan, chief of orthopedic surgery at Lourdes Health Network, wasted no time in putting it to use.

On Wednesday, he performed the nation's 2nd and 3rd (1st and 2nd in New Jersey) opioid-sparing shoulder operations with Exparel.

One patient had a rotator cuff tear, the other had a tear in the labrum, the cup-shaped rim of cartilage surrounding the shoulder socket.

About 48 hours have now passed since the surgery for each, but neither has taken any opioids, able to manage the pain with non-narcotics, like Motrin.

Orthopedic procedures have been one of the prime uses for opioids.

The nation's opioid crisis has doctors looking for alternatives.

"We're trying to get away from the blanket 40-pill prescription after surgery, says Dr. McMillan.

Although many shoulder patients get nerve blocks, their effect wears off in 8 to 12 hours.

"That's when they get a sudden rush of pain," says Dr McMillan. "Similar to when you've been sitting on your foot. When you get up, you feel all those pins and needles," he continued.

But with the new approach with the nerve block, the anesthesia team, led by Dr. Andy Assiamah, is able to get the Exparel nerve block to control pain for 48 to 72 hours.

Dr. McMillan says Exparel has been in use for open surgery, in knee and shoulder replacements.

However, doctors couldn't get the same pain relief for less-invasive arthroscopic procedures.

Now, they have a way to use Exparel right at the surgical site, closer to the nerve.

Since he tweeted about Exparel, Dr. McMillan has been hearing from colleagues.

"I had about 8 or 9 doctors contact me, and say 'how did you do that?' and 'can my anesthesiologist call your anesthesiologist' to find out how to do it?'" Dr. McMillan told Action News.

He says Exparel use is already covered by insurance, eliminating a common obstacle.

With the first shoulder procedures done, Dr. McMillan plans to explore its use with other arthroscopic operations.

For more information on Exparel, click here.

For more information on Dr. McMillan, click here.
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