Thoracic epidural catheter for postoperative pain control following an ineffective transversus abdominis plane block using liposome bupivacaine

A 24-year-old female with a history of ulcerative colitis underwent colectomy. The patient received an ineffective transversus abdominis plane (TAP) block with liposome bupivacaine (Exparel) intraoperatively and was started on a hydromorphone patient-controlled analgesia 5 hours after the TAP block,...

Full description

Saved in:
Bibliographic Details
Published in:Journal of pain research 2017-01, Vol.10, p.191-196
Main Authors: Terrien, Brian D, Espinoza, David, Stehman, Charles C, Rodriguez, Gabriel A, Connolly, Nicholas C
Format: Article
Language:English
Subjects:
Analgesics
Anesthesia
Anesthesiology
Bupivacaine
Care and treatment
Case Report
Case studies
Catheters
Dosage and administration
Inflammatory bowel disease
Joint surgery
Liposome bupivacaine (Bupivacaine Liposome Injectable Suspension)
Narcotics
Pain management
plasma bupivacaine levels
Postoperative pain
Risk factors
Thoracic Epidural
Transversus Abdominis Plane (TAP) nerve block
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A 24-year-old female with a history of ulcerative colitis underwent colectomy. The patient received an ineffective transversus abdominis plane (TAP) block with liposome bupivacaine (Exparel) intraoperatively and was started on a hydromorphone patient-controlled analgesia 5 hours after the TAP block, which did not relieve her pain. A continuous thoracic epidural (CTE) was then placed after blood levels of bupivacaine were drawn, and the patient immediately experienced significant pain relief. The combined use of liposome bupivacaine and bupivacaine CTE infusion in the postoperative management of this patient demonstrated no safety concerns, provided excellent analgesia and plasma concentrations of bupivacaine remained far below toxic levels.
ISSN:1178-7090
1178-7090
DOI:10.2147/JPR.S111589