Author(s)

Charles Keilin¹, Evan P. Salant¹, Charusheela Andaz², Reet Lawhon^1*, Piyush Gupta¹, Dennis E. Feierman¹

¹Department of Anesthesiology, Maimonides Medical Center, Brooklyn, USA.
²Department of Surgery, Maimonides Medical Center, Brooklyn, USA.

Background: Obesity, particularly in the setting of comorbid disease, presents a unique challenge. Clinicians are pursuing areas of multimodal analgesia in an effort to minimize narcotic dosages. Post-operatively, their pain management can be even more challenging, which includes appropriate use of narcotics in a patient that has a high probably of sleep apnea. Aim: To show that the use of liposomal bupivacaine (Exparel) can provide effective post-operative pain relief and decrease the use of post-operative narcotics. Case: We report on a 62 years old female with a history of hypertension, obesity and a greater than a 40 pack year history of smoking who presented for a modified radical mastectomy with a lymph node dissection. At the end of the case, the patient’s wound was infiltrated with both free bupivacaine and Exparel that minimized her need for post-operative narcotics. Conclusion: We believe that the use of extended release local anesthetics should be considered when there is a need to reduce the use of post-operative narcotics.

Liposomal Bupivacaine, Exparel, Narcotic Sparing

Keilin, C. , Salant, E. , Andaz, C. , Lawhon, R. , Gupta, P. and Feierman, D. (2015) Use of Liposomal Bupivacaine (Exparel) for Reduction in the Use of Postoperative Narcotics in an Obese Patient Undergoing Modified Radical Mastectomy. Open Journal of Anesthesiology, 5, 113-115. doi: 10.4236/ojanes.2015.56021.