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

Mojtaba Fayezizadeh, Arnab Majumder, Ruel Neupane, Heidi L. Elliott, Yuri W. Novitsky

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

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 <.001), POD1 (4.2 vs 5.5, P = .002), and POD2 (3.9 vs 4.8, P = .04). In addition, TAP-group demonstrated significantly shorter time to oral narcotics (2.7 days vs 4.0 days, P <.001) and median LOS (5.2 days vs 6.8 days, P = .004). Conclusions TAPb with LB demonstrated significant reductions in narcotic consumption and improved pain control. TAPb allowed for earlier discontinuation of intravenous narcotics and shorter LOS. Intraoperative TAPb with LB appears to be an effective adjunct for perioperative analgesia in patients undergoing open AWR.

Original languageEnglish
Pages (from-to)399-405
Number of pages7
JournalAmerican journal of surgery
Volume212
Issue number3
DOIs
StatePublished - Sep 1 2016

Keywords

  • Abdominal wall reconstruction
  • Hernia repair
  • Liposomal bupivacaine
  • Narcotic consumption
  • Pain reduction
  • Transversus abdominis plane block

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