Preventing addiction: Local doctor uses innovative technique to pain after surgery

Posted at 10:00 PM, Dec 28, 2016
and last updated 2016-12-28 22:00:20-05

A Palm Beach County shoulder surgeon has found an innovative technique that could cut down on opioid overdoses by decreasing his patient’s pain post-op, in turn, limiting their need for drugs.

Dr. Howard Routman, a leading shoulder specialist in Florida, said he is reducing his patients’ pain by injecting a new, local anesthetic called Exparel into the shoulder during surgery. 

“It reduced their pain level by half and also reduced the amount of narcotic that they required to get to that level by half as well,” said Routman.

Exparel, a numbing medication packaged to slowly dissolve over 72 hours, controls pain before it even begins.

“When the medication wears off the patient just has a little bit of soreness and that can be managed with less strong medication,” Routman said.

Dr. Routman operated on both of Martha Nungesser’s shoulders. She said needing less medication was a desirable quality. 

“I generally try to steer clear of pain medication especially the more addictive kinds,” said Nungesser.

Nungesser had Exparel injected in both of her shoulders. 

“I didn’t have any pain immediately after the surgery,” said Nungesser.  “I know it’s highly unusual but that is what my experience was.”

It wasn’t until 13 hours after surgery, Nungesser said, that she needed any extra medication cutting down on the narcotics she needed dramatically.  Without the injections, Dr. Routman said that is unheard of.

“Narcotics are effective, they do a really good job, that is why they exist,” he said. “But if we can find a way to adequately control patients’ pain without the use of narcotics then we can reduce the narcotic load being experienced by the community.”

Although Exparel is new, according to Routman, this same type of treatment has been used during other orthopedic surgeries with similar beneficial results. He said not only does Exparel reduce the risk of becoming dependent on pain medication, but it also cuts down on time at the hospital saving money in medical bills.