The primary outcome for this study is the Numeric Pain Score (NPS) for elective patients undergoing elective colorectal surgery that have been randomized to transversus abdominis plane block or epidural anesthesia for the management of perioperative pain in elective colorectal surgery.
Adequate peri-operative analgesia is a vital component of post-operative management for patients undergoing colon and rectal surgery, affecting hospital length of stay, quality of life, and patient outcomes. There are many options for the peri-operative management of pain after elective colorectal surgery. This is a randomized clinical trial comparing the transversus abdominis plane block using Exparel® to epidural anesthesia for the enhanced recovery pathway perioperative management of pain for elective colorectal surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
200
This is a one time injection of Exparel in the plane between the internal oblique and transversus abdominis muscles
Epidural catheter placed prior to the operation in the standard fashion
Saint Joseph Mercy Hospital
Ann Arbor, Michigan, United States
Post-operative Mean Numeric Pain Scale.
Measured by patient completing the Numeric Pain Scale (NPS) on post-operative day 0,1,2,3. Numeric Pain Scale is a pain screening tool, commonly used to assess pain severity at that moment in time using a 0-10 scale, with zero meaning "no pain" and 10 meaning "the worst pain imaginable". Data from all the specified time points above (post-operative day 0,1,2,3) was averaged into a single value.
Time frame: Post-operative day 0,1,2,3
Overall Benefits of Analgesia Score (OBAS)
Measured by the patient completing the OBAS survey on postoperative days 0,1,2,3. The OBAS is a multi-dimensional quality assessment instrument to measure patients' benefit from postoperative pain therapy. 1\. Rate your current pain at rest on a scale between 0=minimal pain and 4=maximum imaginable pain 2-6. Grade any distress and bother from vomiting in the past 24 h (0=not at all to 4=very much: same scale for remaining Qs about itching, sweating, freezing, dizziness on the scale). 7\. Rate your satisfaction with your pain treatment on a scale between 0=not at all and 4= very much To calculate the OBAS score, compute the sum of scores in items 1-6 and add the '4-(score in item 7)'. The range of scores is from 0 (best) to 28 (worst). Data from all the specified time points above (post-operative day 0,1,2,3) was averaged into a single value.
Time frame: Post-operative day 0,1,2,3
Patient Use of Narcotic Analgesia Post-op Day 0
Patient use of narcotic analgesia post-operative day 0 including Fentanyl from epidural
Time frame: Post-operative day 0
Patient Use of Narcotic Analgesia Post-operative Day 0
Patient use of narcotic analgesia post operative day 0 excluding Fentanyl from epidural.
Time frame: Post-operative day 0
Patient Use of Narcotic Analgesia Post-operative Day 3
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Patient use of narcotic analgesia post-operative day 3 including Fentanyl from epidural
Time frame: Post-operative day 3
Patient Use of Narcotic Analgesia Post-operative Day 1
Patient use of narcotic analgesia post operative day 1 including Fentanyl from epidural
Time frame: Post-operative day 1
Patient Use of Narcotic Analgesia Post-operative Day 2
Patient use of narcotic analgesia post operative day 2 including Fentanyl from epidural
Time frame: Post-operative day 2