Roughly 39.4 million Americans undergo surgery each year.

Why it's important: For many patients, surgery is an important step toward returning to the activities and routines they value.

• While the procedure itself is often the focus of pre-operative conversations, patients may have lingering questions about what recovery will look like once they return home.

The background: The days leading up to surgery can be nerve-wracking, particularly when patients are unsure what to expect.

• Pre-operative conversations typically cover what the procedure will involve and how pain will be managed during surgery.
• What may receive less attention is how pain will be managed afterward, including once the patient is at home.

Here's the deal: Opioids have long been used to help manage postsurgical pain. While opioids may be an appropriate option for some patients, they can also be associated with side effects such as nausea, dizziness and drowsiness and may not be suitable for everyone.

• As health care professionals continue to look for individualized approaches to postsurgical pain management, non-opioid options may be part of the conversation for appropriate patients and procedures.

🧑‍⚕️An alternative approach to managing pain

One physician taking this approach is Ian Byram, MD, who is focused on helping patients manage postsurgical pain while considering ways to reduce reliance on opioids.

• As an orthopedic surgeon, Dr. Byram has spent many years helping patients navigate recovery and understand their pain management options.

Here's how: A key part of his approach is using EXPAREL® (bupivacaine liposome injectable suspension), a long-acting non-opioid local anesthetic administered at the time of surgery.

• Injected directly into the surgical site, EXPAREL slowly releases medication to provide targeted, long-lasting pain relief during the first few days after surgery, when postsurgical pain may be most significant.

"Early in my career, I was taught that post-operative pain management often centered on opioids, with limited alternative options," Dr. Byram says. "After seeing some of the unwanted side effects firsthand, I began exploring additional approaches, including non-opioid options like EXPAREL."

The impact: Some of Dr. Byram's patients began reporting improved pain control after surgery, with many relying less on opioids during recovery.

• "Our goal is always to help patients feel confident heading into recovery, and this option has provided us with another approach to support that goal," he says.

📝Planning for recovery

Preparation for recovery begins long before surgery, often during the pre-operative period, when patients and their health care professionals discuss the procedure, pain-management options and what to expect afterward.

• "It's crucial that patients understand that they have options when it comes to post-operative pain management and that it's not a one-size-fits-all approach," Dr. Byram says.

Take note: Patients can start the conversation with their health care provider by asking:

• How will my pain be managed at home?
• What can I do to reduce my reliance on opioids?
• When can I expect to return to my daily activities?
• Could a non-opioid option like EXPAREL be appropriate for my procedure?
• How would EXPAREL fit into my overall pain-management plan?

Because every pain management plan should be tailored to the individual, it's important to ask whether a particular approach is appropriate for them and their procedure.

"Coming prepared with questions about pain-management options is an important first step," Dr. Byram says. "Being informed can help patients feel more prepared for surgery and advocate for the care that is right for them."

The takeaway: Surgery can be daunting for any patient, whether they're teenagers anticipating wisdom tooth extraction or older adults preparing for a hip replacement.

• By asking the right questions and exploring approaches that may include non-opioid options like EXPAREL, patients can feel more informed, confident, and prepared heading into their recovery.

Learn more.

Dr. Byram is a consultant of Pacira BioSciences, Inc., manufacturer of EXPAREL. This is based on Dr. Byram's experiences. Individual patient experience may vary.

INDICATION

EXPAREL® (bupivacaine liposome injectable suspension) is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block. Safety and efficacy have not been established in other nerve blocks.

IMPORTANT SAFETY INFORMATION

EXPAREL should not be used in obstetrical paracervical block anesthesia.

In studies in adults where EXPAREL was injected into a wound, the most common side effects were nausea, constipation, and vomiting.

In studies in adults where EXPAREL was injected near a nerve, the most common side effects were nausea, fever, headache, and constipation.

In the study where EXPAREL was given to children, the most common side effects were nausea, vomiting, constipation, low blood pressure, low number of red blood cells, muscle twitching, blurred vision, itching, and rapid heartbeat.

EXPAREL can cause a temporary loss of feeling and/or loss of muscle movement. How much and how long the loss of feeling and/or muscle movement depends on where and how much of EXPAREL was injected and may last for up to 5 days.

EXPAREL is not recommended to be used in patients younger than 6 years old for injection into the wound, for patients younger than 18 years old for injection near a nerve, and/or in pregnant women.

Tell your health care provider if you or your child has liver disease, since this may affect how the active ingredient (bupivacaine) in EXPAREL is eliminated from the body.

EXPAREL should not be injected into the spine, joints, or veins.

The active ingredient in EXPAREL can affect the nervous system and the cardiovascular system; may cause an allergic reaction; may cause damage if injected into the joints; and can cause a rare blood disorder.

Please refer to full Prescribing Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

© 2026 Pacira Pharmaceuticals, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc. EXPAREL is a registered trademark of Pacira Pharmaceuticals, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc. All rights reserved.

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