Shoulder doc says anesthetic avoids opioid use
ATLANTIS — Shoulder replacement is a notoriously painful procedure, one that typically requires a costly hospital stay and a big bottle of pain pills.
Dr. Howard Routman, an Atlantis shoulder surgeon, said he has found a way to control patients’ pain and limit their use of potentially addictive opioids. Routman injects a local anesthetic made by Pacira Pharmaceuticals Inc. (Nasdaq: PCRX, $30.85) of Parsippany, N.J., into patients during shoulder replacement — and, as a result, patients suffer less pain and pop fewer pills.
Routman recently published the results of his research in the Journal of Shoulder and Elbow Surgery.
During 2013 and 2014, Routman tracked 55 patients who underwent shoulder replacement at JFK Medical Center. One group managed pain with the usual recipe of post-operative opioids. The other group received injec- tions of Exparel, which sells for $280 a vial.
Patients who received Exparel used half as much opiates after surgery, spent half as much time in the hospital and reported half as much pain when asked to judge their discomfort on a scale of 0 to 10.
Exparel is a local anesthetic. The painkiller’s time release lets it last for three days — enough time, Routman said, to block the most intense pain caused by surgery.
Routman said he still prescribes Percocet and other opioids, but many patients report only mild discomfort after surgery.
“More and more, people are coming to the office and saying, ‘I really didn’t need all that,’” Routman said.
As a re sul t , Routman s a i d, “We’re able to do outpatient shoulder replacement now.”
Older patients tend to suffer side effects from narcotic painkillers, and addiction is a threat for anyone who takes prescription pills.
“We are hearing more and more about physicians telling us that their patients are coming in and talking about not wanting opioids for their surgical procedures,” Pacira Chairman and Chief Executive Dave Stack said in a recent conference call.
Pacira reported a profit of $1.9 million on sales of $249 million in 2015.
Routman has a consulting agreement with Pacira, although he said he wasn’t paid by the company until after he conducted his research.