Greenwich Doctor Uses New Approach To Reduce Post-Surgery Pain

GREENWICH, Conn. — A Greenwich orthopedic sports surgeon is taking a unique approach to help his patients manage pain from surgery.

Paul Sethi
Paul Sethi Photo Credit: Contributed

Dr. Paul Sethi of ONS can inject a numbing medication called Exparel during surgery, which can reduce — or even completely eliminate — the need for his patients to have prescription opioids post-surgery.

“They can recover faster, they can have less pain, they can have fewer consequences and side effects, and they don’t have that exposure to narcotics,” Sethi told Daily Voice.

The medication is a similar concept to novocaine, which is commonly used at the dentist. But traditional novocaine lasts for about an hour. And even the more advanced versions of novocaine can last only 12 to 16 hours.

But Sethi said the effects of Exparel, which is released in a slow-release fashion, can last for three days in the body.

After the effects of Exparel wear off, a patient might be able to alleviate the pain and discomfort of surgery with over-the-counter medications such as Tylenol or Advil, “which are really fantastic pain medications in of themselves,” Sethi said.

Since Sethi started using Exparel over the past four or five months during surgery, he said almost half of his shoulder surgery patients have not had to take any narcotic pain medications.

Sethi cautioned that not all patients are able to forgo traditional pain medications. “There are certainly some people who require some pain medication,” Sethi said.

In the past, patients had to spend days or weeks in the hospital. Now, with advancements such as Exparel, a patient can “go home same day as [their] procedure and expect the same safe outcome,” Sethi said. “It’s a real advancement in healthcare.”

One of Sethi's patients, a 71-year-old woman, battled shoulder pain from arthritis and playing golf. Even though she tried physical therapy, exercise and other remedies, she still struggled with pain.

When she had surgery, she had a quick and relatively painless recovery. The patient went out to dinner with friends the next day.

Sethi said he has colleagues in different parts of the U.S. using Exparel. But like any medication, Sethi said doctors need to study Exparel and learn how to best use it. 

“There are specific nuances and techniques on how to administer it most correctly,” he said.

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