Efficacy of transversus abdominis plane block with liposomal bupivacaine during open abdominal wall reconstruction

Abstract Background Transversus abdominis plane block (TAPb) is an analgesic adjunct used for abdominal surgical procedures. Liposomal bupivacaine (LB) demonstrates prolonged analgesic effects, up to 72 hours. We evaluated the analgesic efficacy of TAPb using LB for patients undergoing open abdomina...

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Bibliographic Details
Published in:The American journal of surgery 2016-09, Vol.212 (3), p.399-405
Main Authors: Fayezizadeh, Mojtaba, M.D, Majumder, Arnab, M.D, Neupane, Ruel, B.S, Elliott, Heidi L., M.D, Novitsky, Yuri W., M.D
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Muscles - innervation
Abdominal Muscles - surgery
Abdominal surgery
Abdominal wall reconstruction
Abdominoplasty - methods
Anesthetics, Local - administration & dosage
Body mass index
Bupivacaine - administration & dosage
Cholecystectomy
Chronic obstructive pulmonary disease
Drug dosages
Female
Follow-Up Studies
Health risk assessment
Hernia repair
Hospitalization
Humans
Laparoscopy
Liposomal bupivacaine
Liposomes
Male
Medical personnel
Middle Aged
Narcotic consumption
Narcotics
Nerve Block - methods
Nonsteroidal anti-inflammatory drugs
Pain
Pain Management - methods
Pain Measurement
Pain reduction
Pain, Postoperative - diagnosis
Pain, Postoperative - therapy
Patients
Postoperative period
Prospective Studies
Studies
Surgery
Transversus abdominis plane block
Treatment Outcome
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Summary:Abstract Background Transversus abdominis plane block (TAPb) is an analgesic adjunct used for abdominal surgical procedures. Liposomal bupivacaine (LB) demonstrates prolonged analgesic effects, up to 72 hours. We evaluated the analgesic efficacy of TAPb using LB for patients undergoing open abdominal wall reconstruction (AWR). Methods Fifty patients undergoing AWR with TAPb using LB (TAP-group) were compared with a matched historical cohort undergoing AWR without TAPb (control group). Outcome measures included postoperative utilization of morphine equivalents, numerical rating scale pain scores, time to oral narcotics, and length of stay (LOS). Results Cohorts were matched demographically. No complications were associated with TAPb or LB. TAP-group evidenced significantly reduced narcotic requirements on operative day (9.5 mg vs 16.5 mg, P = .004), postoperative day (POD) 1 (26.7 mg vs 39.5 mg, P = .01) and POD2 (29.6 mg vs 40.7 mg, P = .047) and pain scores on operative day (5.1 vs 7.0, P
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.12.026