Analgesic efficacy of laparoscopic-guided transverse abdominis plane block using liposomal bupivacaine in bariatric surgery

Am J Surg. 2018 Apr;215(4):643-646. doi: 10.1016/j.amjsurg.2017.09.006. Epub 2017 Sep 20.

Abstract

Background: Postoperative pain management is a major contributor to recovery and discharge in bariatric surgery. Local anesthetic agents are of particular interest: they're non-sedating and may reduce postoperative pain and hospital length of stay (LOS).

Design: Researchers queried the Bariatric Surgery Service Database for patients undergoing laparoscopic weight loss surgery from January 2012-December 2014. Patients were divided between those who did and did not receive liposomal bupivacaine intra-operatively. Measures included demographics, narcotic use, LOS, antiemetic use, and pain scales.

Results: The liposomal group consisted of 233 patients and the PCA group consisted of 243 patients. The liposomal group had significantly less narcotic use than the PCA group in terms of IV morphine equivalents. This did not translate into a reduction in LOS in the liposomal group.

Conclusions: TAP block using liposomal bupivacaine provides effective analgesia comparable to PCA.

MeSH terms

  • Abdominal Muscles / surgery*
  • Analgesics, Opioid / administration & dosage
  • Anesthetics, Local / administration & dosage*
  • Antiemetics / administration & dosage
  • Bariatric Surgery*
  • Bupivacaine / administration & dosage*
  • Female
  • Humans
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Liposomes
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain Management
  • Pain Measurement
  • Pain, Postoperative / prevention & control*
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Antiemetics
  • Liposomes
  • Bupivacaine