Postoperative Analgesia in Laparoscopic Abdominal Surgery After Exparel Via TAP or Local Infiltration

University of Washington

Status: Unknown

Conditions: Anesthesia; Functional; Anesthesia, Local; Pain, Postoperative; Opioid Use; Anesthesia

Treatments: Drug: Exparel 266 MG Per 20 ML Injection

Study type: Interventional

Funder types: Other

Identifiers

NCT03927326

STUDY00007182

Details and patient eligibility

About

This study evaluates differences in how administering liposomal bupivacaine via two different methods affects postoperative pain control in laparoscopic abdominal surgery patients. Half the participants will receive liposomal bupivacaine via a transverses abdominis plane block while the other half will receive liposomal bupivacaine via local infiltration.

Full description

Liposomal bupivacaine is a newer formulation of a local anesthetic that is commonly used for local infiltration, peripheral nerve blocks, and neuraxial anesthesia. This new formulation allows the effects of bupivacaine to last up to 72 hours as it is slowly released from a liposome. It is FDA approved for local infiltration and has recently been approved for interscalene blocks.

A transversus abdominis plane block is a fascial plane block that is performed routinely for postoperative pain relief for some abdominal incisions. It is performed by placing local anesthetic between the internal oblique and transverses abdominis muscle planes where it will provide analgesia to several dermatomes of the abdomen in hopes of improving postoperative pain relief and reducing postoperative opioid requirement.

Enrollment: 150 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients scheduled for elective laparoscopic colorectal surgery at UWMC requiring inpatient stay

Exclusion criteria

• Patients on chronic pain mediations equaling or exceeding > 25 morphine daily equivalents
• Patients allergic to bupivacaine
• Patients with ASA status IV, V, or VI
• Patients unable to consent
• Patients that are pregnant
• Patients that are incarcerated
• Patients receiving procedures in addition to laparoscopic colorectal procedure
• Patients on systemic anticoagulation precluding them from regional blocks

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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150 participants in 2 patient groups

Local infiltration

Experimental group

Description:

Liposomal bupivacaine (266mg) will be directly infiltrated by the surgeon into the surgical laparoscopic wound sites.

Treatment:

Drug: Exparel 266 MG Per 20 ML Injection

Transversus abdominis plane block

Experimental group

Description:

Liposomal bupivacaine (266mg) will be used in a ultrasound guided transversus abdominis plane block.

Treatment:

Drug: Exparel 266 MG Per 20 ML Injection