Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review

• Published in: Journal of pain research 2018-01, Vol.11, p.3109-3116
• Main Authors: Baker, B Wycke, Villadiego, Lea G, Lake, Y Natasha, Amin, Yazan, Timmins, Audra E, Swaim, Laurie S, Ashton, David W
• Format: Article
• Language: English
• Subjects: Aircraft; Analgesia; Analgesics; Analysis; Anesthesia; Anesthesiology; Bupivacaine; Cesarean section; Clinical trials; Consumption data; Disease control; Drug dosages; FDA approval; Health risk assessment; Hospitals; Internet; liposomal bupivacaine; Nalbuphine; Narcotics; Opioids; Original Research; Pain management; Patients; Postoperative pain; postoperative pain management; Surgeons; Surgery; Systematic review; transversus abdominis plane block; Womens health
• ISSN: 1178-7090; 1178-7090
• DOI: 10.2147/JPR.S184279

Adverse effects of opioid analgesics and potential for chronic use are limitations in the cesarean setting. Regional anesthesia using transversus abdominis plane (TAP) block post-cesarean delivery may improve analgesia and reduce opioid consumption. Effectiveness of TAP block using liposomal bupivacaine (LB) to reduce post-cesarean pain is unknown. We performed a single-center retrospective chart review of patients aged ≥18 years who underwent cesarean delivery with a multimodal pain management protocol with or without TAP block with LB 266 mg. Assessments included postsurgical opioid consumption; area under the curve (AUC) of numeric rating scale pain scores from 0 to 3 days; proportion of opioid-free patients; discharge- and post-anesthesia care unit (PACU)-ready time; times to ambulation, solid food, and bowel movement; hospital length of stay (LOS); and adverse events (AEs). Data were analyzed in the total population and in first- and repeat-cesarean subgroups using Wilcoxon, chi-squared, and Student's tests. Of 201 patients, 101 were treated with LB TAP block (LB-TAPB) and 100 without LB-TAPB. Treatment with LB-TAPB vs without LB-TAPB significantly reduced mean post-surgical opioid consumption (total, 47%; first-cesarean, 54%; repeat-cesarean, 42%;