SOURCE: North American Partners in Anesthesia

North American Partners in Anesthesia

December 09, 2014 10:00 ET

Dr. Joseph Marino Developing Opioid-Reducing Postoperative Pain Management Protocol

Results Will Lead to Improvements in Patient Recovery

MELVILLE, NY--(Marketwired - December 09, 2014) - North American Partners in Anesthesia (NAPA) anesthesiologist, Joseph Marino, MD recently announced that his research team is conducting a study to develop a multimodal analgesic technique for patients experiencing postoperative pain after undergoing a Total Knee Arthroplasty (TKA). In the study, Dr. Marino and his research team will compare EXPAREL® (bupivacaine liposome injectable suspension) administered via infiltration into the surgical site to the current standard of care, continuous femoral nerve block in the management of TKA postoperative pain. The objective of his research is to provide patients with optimal pain relief while minimizing or eliminating all together, the use of opioids and their related adverse effects such as nausea, vomiting, constipation, urinary retention, confusion, and respiratory depression.

Secondary objectives of this study include the comparison of both groups for preservation of quadriceps muscle strength and the achievement of important functional recovery milestones. Dr. Marino will be studying such outcomes that include the following measurements: total amount of opioid used, time to first opioid rescue, post-operative nausea and vomiting and patient satisfaction. In addition, he will be focusing on the serum bupivacaine levels to assess the toxic threshold of the local anesthetic. Measuring the threshold of how close the local anesthetic approaches LAST (local anesthetic systemic threshold) will serve as an essential metric to anesthesiologists and orthopedists to ensure the safety of their patients. Recruitment for subject participation in the trial began in November 2014.

"Despite improvements in pain control practices, many patients experience unacceptable levels of postoperative pain," said Dr. Marino. "Pain following orthopedic surgery is considered especially difficult to manage, with pain after TKA reported to be extreme and prolonged in half of all patients. With the importance of early ambulation after TKA for the prevention of thromboembolic complications, there is a clear clinical benefit to exploring alternative techniques that help minimize postoperative pain that are as effective as continuous nerve blocks but do not cause weakness of the quadriceps muscle. Through this research, I am looking to revolutionize the way that we practice postoperative pain medicine with the elimination of opioids while still providing continuous and extended pain relief to our patients."

Dr. Marino serves as a Chief of Anesthesia for Franklin and Syosset Hospitals. In addition, he holds positions as the Director of Regional Anesthesia for the North Shore-LIJ Health System and as associate professor of anesthesiology at the Hofstra North Shore-LIJ School of Medicine. Dr. Marino received his medical degree from New York Medical College and fulfilled his residency in anesthesiology at Yale-New Haven Hospital, New Haven, CT, as well as at Shands Hospital, University of Florida, Gainesville, FL.

EXPAREL is indicated for single-dose administration into the surgical site to produce postsurgical analgesia.

About North American Partners in Anesthesia
Founded in 1986, North American Partners in Anesthesia (NAPA) is the leading single specialty anesthesia management company in the United States. NAPA is comprised of the most respected clinical staff, providing thousands of patients with superior and attentive care. The company is known for partnering with hospitals and other health care facilities across the nation to provide anesthesia services and perioperative leadership that maximize operating room performance, enhance revenue, and demonstrate consistent patient and surgeon satisfaction ratings. For more information, please visit

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