The transversus abdominis plane (TAP) block can be used to reduce pain in patients who get abdominal surgery. TAP blocks are given with a local anesthetic. The purpose of this study is to compare pain medication usage after surgery between two different types of local anesthetic: liposomal bupivacaine and standard bupivacaine.
Pain control is a factor that is central to the surgical patient's postoperative experience. Opioid pain medications are a mainstay of postoperative pain management. However, these have several adverse effects. Multimodal pain regimens to minimize opioid use have become central to enhanced recovery after surgery (ERAS) protocols. The transversus abdominis plane (TAP) block is one intervention that contributes to this regimen. Traditionally, TAP blocks are performed with local anesthetics such as bupivacaine. More recently, these have also been performed with liposomal bupivacaine, whose duration of action is much greater than regular bupivacaine (96 hours versus 8-9 hours, respectively). In this study, postoperative opioid usage will be compared between patients receiving regular bupivacaine and liposomal bupivacaine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
63
Abdominal injection of bupivacaine into fascial layer.
Abdominal injection of bupivacaine liposome into fascial layer.
Fairfax Colon & Rectal Surgery, Alexandria Office
Alexandria, Virginia, United States
Fairfax Colon & Rectal Surgery, Fairfax-Prosperity Office
Fairfax, Virginia, United States
Fairfax Colon & Rectal Surgery, Fair Oaks Office
Fairfax, Virginia, United States
Inova Fairfax Medical Campus
Falls Church, Virginia, United States
In-hospital Postoperative Opioid Consumption
Daily overall opioid use recorded as morphine equivalents
Time frame: up to postoperative day 3 at 1 pm
Pain Score
Recorded on a scale of 0 (No pain) to 10 (Worst possible pain)
Time frame: Approximately every 6 hours through postoperative day 3 by 1 pm
Time to Patient Mobilization
Number of days from day of surgery until patient mobilization
Time frame: From time of surgery until time of first patient ambulation post op. Assessed until date of discharge (usually up to 4 days after surgery).
Time to Return of Bowel Function
Number of days from time of surgery until return of bowel function
Time frame: From time of surgery until first time patient passes gas or stool per rectum or into ostomy bag. Assessed until date of discharge (usually up to 4 days after surgery).
Time to Clear Liquid Diet
Number of days from time of surgery until patient tolerates clear liquid diet
Time frame: From time of surgery until first time patient tolerates clear liquids without nausea or vomiting. Assessed until date of discharge (usually up to 4 days after surgery).
Time to Low Fiber Diet
Number of days from day of surgery until patient tolerates low fiber diet
Time frame: From time of surgery until first time patient tolerates a low fiber diet without nausea or vomiting. Assessed until date of discharge (usually up to 4 days after surgery).
Length of Stay
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Fairfax Colon & Rectal Surgery, Loudoun Office
Lansdowne Town Center, Virginia, United States
Fairfax Colon & Rectal Surgery, Reston Office
Reston, Virginia, United States
Total postoperative hospital stay in days
Time frame: Date of surgery to date of discharge (usually up to 4 days after surgery).
In-hospital Antiemetic Use
Amount of ondansetron patient required postoperatively during hospital stay, in milligrams
Time frame: Time of transfer to post operative suite to time of discharge (usually up to 4 days after surgery).
Complications
Patient suffered a complication (infection, small bowel obstruction, dehydration, deep vein thrombosis/pulmonary embolism, anastomotic leak, cardiac arrest, stroke, sepsis) after surgery
Time frame: Within 30 days of surgery
Readmissions
Patient readmitted to hospital after discharge
Time frame: Within 30 days of hospital discharge
Mortality
Patient death after surgery
Time frame: Within 30 days of surgery
Hospitalization Costs
Total hospitalization costs per patient per this surgical encounter
Time frame: From date of this surgical admission to date of this surgical discharge (usually up to 4 days after surgery).