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YOUR HEALTH: New pain management that eliminates opioids

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MIAMI, Florida – Jessica Garcia was born with a hole in her heart.

"When I was born they told my parents that I probably wouldn't make it a week, or a month or anything."

At age 13, Jessica needed surgery to repair the VSD, or ventricular septal defect.

"I was down for it, I was totally cool about it."

Being told your child needs open heart surgery is frightening enough.   A major concern is the pain after the procedure.

Now a new type of anesthesia is proving to be a real game changer in the operating room.

"We're actually seeing an increasing number of children, not only neonates and infants, toddlers and children, adolescents who require open heart surgery," said Nicklaus Children's Hospital pediatric heart surgeon Dr. Kristine Guleserian

She says most parents have the same concern.

"Is my child going to be okay, are they going to be in pain after surgery?"

Now doctors have a new weapon in the fight against post-surgical pain in children: it's called Exparel.

"It's a local analgesic that we can inject in and around the incision after we have completed the open heart procedure," explained Dr. Guleserian.

The medication then slowly releases over three days.   Surgeons are calling Exparel a real game changer.

"It will reduce the need for supplemental analgesics, particularly opioid analgesics," said Dr. Christopher Tirotta, the director of cardiac anesthesia at Nicklaus Hospital.

OPIATE DEPENDENCE AFTER SURGERY:   Most patients are given pain-blocking medications before, during, and after their surgical procedure.   Prescription painkillers are highly effective and allow doctors to treat and fix certain medical problems that would otherwise be far too painful to address.   These painkillers are often given intravenously before and during the procedure, and often given in pill form during recovery.   As helpful as they can be, these can also trigger the onset of addiction.   A vast majority of these medications are opiates, which are directly related to heroin, and the risk of dependence is very high.  (Source:

Jessica was the first patient at Nicklaus Children's Hospital to receive Exparel after her heart surgery.   The next day she woke up smiling.

"That day I wanted to run, walk, do everything," she remembered,    "I told my parents can I get up from the bed, I'm tired of the bed."

With the operation behind her, Jessica is back to being a busy teenager.

"It's unreal to me how easy I got out of this and how thankful I am."

Jessica says she wants to become a doctor when she grows up.

Already FDA-approved for adults.

Right now, Exparel is being used "off-label" for kids if they are over the age of 12 since it is not FDA approved for children.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at or Marjorie Bekaert Thomas at

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