{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T07:54:11Z","timestamp":1781510051434,"version":"3.54.1"},"reference-count":20,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Objectives:<\/jats:title>\n \n To evaluate the effects of using Exparel\n \u00ae<\/jats:sup>\n bupivacaine liposome suspension 1.3% (13.3\u2009mg\/mL) as an adjunct to standard of care medication in adult tonsillectomy patients.\n <\/jats:p>\n <\/jats:sec>\n \n Study Design:<\/jats:title>\n Randomized controlled trial.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Community Hospital.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n The study arm (n\u2009=\u200922) received Exparel\n \u00ae<\/jats:sup>\n bupivacaine liposome suspension 1.3% (13.3\u2009mg\/mL) as an adjunct to the standard of care (SOC) medication bupivacaine HCl 0.25% (2.5\u2009mg\/mL) with epinephrine (5\u2009\u03bcg\/mL). The control group (n\u2009=\u200920) received SOC bupivacaine HCl 0.25% with epinephrine (5\u2009\u03bcg\/mL). All injections were administered after the excision of the tonsil, prior to conclusion of the operative procedure. Pre- and post-operative clinicopathologic variables of interest were collated from electronic medical records and daily pain diaries. Results were analyzed via standard univariate statistics, linear mixed models, and Poisson regression.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The Exparel\n \u00ae<\/jats:sup>\n \u2009+\u2009SOC group experienced significantly less pain at post operative day (POD) 3 compared to the control group (\n P<\/jats:italic>\n \u2009<\u2009.05). Mean pain score\n decreased<\/jats:italic>\n on average by 1.23 points in the Exparel\n \u00ae<\/jats:sup>\n \u2009+\u2009SOC group and\n increased<\/jats:italic>\n on average by 0.39 points in the control group (adj.\n P<\/jats:italic>\n -value\u2009<\u2009.001). Similarly, analysis showed that maximum pain score decreased on average by 0.64 points in the Exparel\n \u00ae<\/jats:sup>\n \u2009+\u2009SOC and increased on average by 0.61 points the control group (adj.\n P<\/jats:italic>\n -value\u2009<\u2009.001). There was a statistically significant decrease in dose of oxycodone use between POD 3 and POD 5 within the Exparel\n \u00ae<\/jats:sup>\n \u2009+\u2009SOC group (16.39 vs 7.22\u2009mg,\n P<\/jats:italic>\n -value\u2009=\u2009.035). The relative proportion of patients who took oxycodone was less in the Exparel\n \u00ae<\/jats:sup>\n \u2009+\u2009SOC group compared to the control group across all PODs.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n Use of Exparel\n \u00ae<\/jats:sup>\n in adult tonsillectomy may decrease post-operative opioid use compared to standard of care treatment. These findings may serve as guidance for best practices in adult tonsillectomy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00034894261423285","type":"journal-article","created":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T01:46:49Z","timestamp":1772329609000},"page":"522-529","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exparel\n \u00ae<\/sup>\n (Bupivacaine Liposome Injectable Suspension) as Adjunctive Pain Control in Adult Tonsillectomy: Reducing Post-Operative Opioid Use"],"prefix":"10.1177","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4928-967X","authenticated-orcid":false,"given":"Sarah M.","family":"Dermody","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilana P.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T.","family":"Hoff","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, USA"},{"name":"Department of Surgery, Trinity Health Ann Arbor Hospital, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.6215"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31828866b3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11102713"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usab127"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004619.pub3"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2017.07.018"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0145561319846065"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001874"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12070-017-1058-9"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15299"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-019-0352-9"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0504"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.2217\/pmt.15.58"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2008.01815.x"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(91)90220-R"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_375_15"},{"issue":"2","key":"e_1_3_2_18_2","article-title":"Opioid complications and side effects","volume":"11","author":"Benyamin R","year":"2008","unstructured":"Benyamin R, Trescot AM, Datta S, et al. Opioid complications and side effects. Pain Physician. 2008;11(2):S105-S120.","journal-title":"Pain Physician"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.534"},{"key":"e_1_3_2_20_2","volume-title":"Tonsillectomy and Adenoidectomy","author":"Bohr C","year":"2023","unstructured":"Bohr C, Shermetaro C. Tonsillectomy and Adenoidectomy. StatPearls; 2023."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2023.111455"}],"container-title":["Annals of Otology, Rhinology & Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00034894261423285","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00034894261423285","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00034894261423285","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T07:27:57Z","timestamp":1781508477000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00034894261423285"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":20,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/00034894261423285"],"URL":"https:\/\/doi.org\/10.1177\/00034894261423285","relation":{},"ISSN":["0003-4894","1943-572X"],"issn-type":[{"value":"0003-4894","type":"print"},{"value":"1943-572X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,28]]}}}