72 Hour SensoryNerve Block
•Better Post -Op Pain Control
• Reduce Post-op Narcotic use by 50 -100%
• Earlier Discharge from Hospital: 1-3 days average
• Faster Turn-over in Recovery Room
• Most Versatile Long Acting Local Anesthetic:
• Nerve Block
• Joint Infiltration
• Tissue Infiltration
• Adjustable Degree of Vasoconstriction
• Safest:
• No Cardiotoxicity Risk
• Safe for Intra-articular Injections
• High Volumes to reach Toxicity
• Cheapest:
$4.54 /cc
vs. Exparel: $20/cc
vs. R.E.C.K.: $11.00/cc
Pre-mixed Single-Use 50 cc vial is cheaper than if mixed on-site
One 50cc vial cost $227.00 vs. the same amount of Tetracaine alone would cost > $900.00
• Reimbursement up to $625/50cc bottle: “Narcotic Reduction Act”
Made in the U.S.A.
ALL Mammals • HUMANS • Large Animals • Small Animals • Post Operative Pain Control •
ALL Mammals • HUMANS • Large Animals • Small Animals • Post Operative Pain Control •
Recommended Dosing
•Humans:
• 1.5 ml/kg
• Large Animals- Livestock • Horses:
• 1.5 ml/kg
• Dogs:
• 1 ml/kg
• Cats:
• 0.5 ml/Kg
• Rats • Guini Pigs:
• 1 ml/kg
Examples of Nerve Blocks Currently being Used
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Orthopedic Nerve Blocks
•Interscalene Nerve block: Hand, Elbow, wrist, total Shoulder
•Erector spine blocks: Spine
•Adductor canal +/- into-articular infiltration has been great for total knee
•Fascia iliaca nerve +/- intra-articular infiltration for hip
•Sciatic Nerve @ Popliteal fossa: lower leg:ankle, malleolar fx, Aechilles tendon
•Axillary: elbow, forearm, wrist, hand
-
Plastic Surgery Nerve Blocks
•Abdominoplasty:20cc local infiltration + 30 cc TAP Block or subfascial infiltration
•Breast Augmentation: 5cc/pocket or sub muscular infiltration/side+/- PECS nerve block
•Mommy Makeover: 5cc/breast pocket, or PECS block, remainder for abdominoplasty •Facial: Local Infiltration +/- Capitus nerve blocks
•Tumescent combination
Some of the Facilities Using the EnduraKT
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On-Formulary
Penn State University Health System, PA
Fairfield Memorial Hospital, IL
St. Anthony Regional, IA
Spartanburg Regional Hospital System, SC
Methodist Hospital for Surgery, TX
BSW Baylor Uptown, TX
DHR Health System, TX
Many Surgery Centers
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On-going & Completed Clinical Trials
Sloan Kettering: TAC block side by side comparison of Exparel to Endura
UCSD : data on the inter scalene blocks
NJ Maxilofacial physicians: data on the head & neck nerve blocks
Clinical Studies Summary
-
Adult Colon Resection: 226
Transverse abdominus block:
0 patients discharged on Opioids
Reduced hospitilizations by 1.5 days
< 12 Opioids dispensed
-
Orthopedic
Othopedic:
Total Knee: 58
100% less use of post op analgesics
Regional Anesthesia
Inter-scalene: 192
Axillary: 64
100% used non-opioid analgesia post op
-
Pediatric
Appendectomy: 6
0 post op Opioid use
Next day discharge on Tylenol
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