Anesthesia, Breast Reconstruction, Transverse Abdominis Plane Block
Conditions
Brief summary
This study will compare the efficiency of transversus abominus plane (TAP) block using liposomal bupivacaine versus plain bupivacaine that is administered in the operating room under ultrasound guidance prior to the in patients undergoing abdominally-based free flap breast reconstruction at Vanderbilt University Medical Center.
Detailed description
Transversus Abdominis Plane (TAP) blocks are commonly used as part of Enhanced Recovery After Surgery (ERAS) pathway. This prospective, double-blinded, randomized control trial compares post-operative pain and narcotic consumption after deep inferior epigastric artery perforator (DIEP) breast reconstruction with liposomal bupivacaine (LB) compared to bupivacaine hydrochloride (BHCl). Subjects undergoing DIEP flaps were randomly assigned LB or BHCl, performed using ultrasound-guided TAP block technique pre-procedurally. Primary outcomes were postoperative narcotic analgesia required in oral morphine equivalents (OME) from postoperative day (POD) 0 to 7. Secondary outcomes included POD 1-7 pain Numeric Rating Scale (NRS), non-narcotic pain medication consumption, time to first narcotic use, return of bowel function, and length of stay (LOS).
Interventions
DRUGRegular bupivacaine
20mL of 0.25% bupivacaine injected on each side.
DRUGLiposomal bupivacaine
20mL of Exparel® 1.3% mixed with 20mL of 0.25% bupivacaine, for a total of 40mL of local anesthestic mixture, 20mL to be injected on each side.
Sponsors
Vanderbilt University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Masking description
Participants and plastic surgeons will be blinded to the study treatment arm
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
1. age between 18-85 years 2. males or females 3. plastic surgery for abdominally-based free flap breast reconstruction.
Exclusion criteria
1. those not candidates for TAP blocks due to allergies to the medications (e.g., bupivacaine) 2. those with anatomic contra-indications to performing a TAP block 3. those unwilling to participate in follow-up assessments 4. vulnerable populations 5. chronic pain or associated diagnosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | Postoperative day (POD) 1 to 7 | Amount of supplemental postoperative narcotic analgesia (both intravenous and oral) required by study groups in oral morphine equivalents |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to First Opiate Use | 0-29.8 hours post operation | Time from end of surgery to time of first opioid intake measured in hours |
| Time to Return of Bowel Function | 1 to 4 days post operation | Mean time in days at which patients had a return of bowel movement post op |
| Length of Stay | 1 to 4 days | Length of hospital stay post operatively |
| Ambulation | 1 day post op | Time to first ambulate post op (in days) |
| Pain Measure | Post operative day (POD) 1 to 7 | Pain as measured by numeric rating scale ranging from 0 (no pain) to 10 (worst pain ever). |
| Non Narcotic Pain Medication Intake: Cyclobenzaprine | Post op day 1 to 7 | The total use of the non-narcotic pain medication Cyclobenzaprine was recorded during hospitalization |
| Non Narcotic Pain Medication Intake: Gabapentin | Post op day 1 to 7 | The total use of the non-narcotic pain medication gabapentin was recorded during hospitalization |
| Non Narcotic Pain Medication Intake: Celebrex | post op day 1 to 7 | The total use of the non-narcotic pain medication celebrex was recorded during hospitalization |
| Non Narcotic Pain Medication Intake: Ondansetron | Post op day 1 to 7 | The total use of the non-narcotic pain medication ondansetron was recorded during hospitalization |
| Non-narcotic Pain Medication Intake: Acetaminophen | Post op day 1 to 7 | The total use of the non-narcotic pain medication Acetaminophen was recorded during hospitalization |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine Local analgesia (TAP blocks) will be administered under ultrasound guidance in the operating room after the patient is intubated and under general anesthesia. Under sterile conditions and ultrasound guidance, the fascial plane between the internal oblique and transversus abdominis muscles (muscles of the abdominal wall) will be identified at the anterior axillary line, midway between the costal margin and iliac crest. The epidural needle will be inserted through the skin to the appropriate fascial plane, and the local anesthetic will be injected in that plane. 20mL of Exparel® 1.3% mixed with 20mL of 0.25% bupivacaine, for a total of 40mL of local anesthestic mixture, 20mL to be injected on each side.
Liposomal bupivacaine: 20mL of Exparel® 1.3% mixed with 20mL of 0.25% bupivacaine, for a total of 40mL of local anesthestic mixture, 20mL to be injected on each side. | 30 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine Local analgesia (TAP blocks) will be administered under ultrasound guidance in the operating room after the patient is intubated and under general anesthesia. Under sterile conditions and ultrasound guidance, the fascial plane between the internal oblique and transversus abdominis muscles (muscles of the abdominal wall) will be identified at the anterior axillary line, midway between the costal margin and iliac crest. The epidural needle will be inserted through the skin to the appropriate fascial plane, and the local anesthetic will be injected in that plane. 20mL of 0.25% bupivacaine injected on each side.
Regular bupivacaine: 20mL of 0.25% bupivacaine injected on each side. | 30 |
| Total | 60 |
Baseline characteristics
| Characteristic | Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Total | Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine |
|---|---|---|---|
| Age, Continuous | 53 years STANDARD_DEVIATION 9.5 | 52.6 years STANDARD_DEVIATION 9.6 | 52.2 years STANDARD_DEVIATION 9.8 |
| Body mass index (BMI) | 29.6 kg/m^2 STANDARD_DEVIATION 5.3 | 29.9 kg/m^2 STANDARD_DEVIATION 4.8 | 30.2 kg/m^2 STANDARD_DEVIATION 4.3 |
| Deep Inferior Epigastric Artery Perforator (DIEP) Laterality Bilateral DIEP | 21 Participants | 44 Participants | 23 Participants |
| Deep Inferior Epigastric Artery Perforator (DIEP) Laterality Unilateral DIEP | 9 Participants | 16 Participants | 7 Participants |
| Diabetic | 8 Participants | 14 Participants | 6 Participants |
| DIEP timing Delayed DIEP | 25 Participants | 49 Participants | 24 Participants |
| DIEP timing Immediate DIEP | 5 Participants | 11 Participants | 6 Participants |
| History of hormonal therapy (HT) Current HT | 13 Participants | 23 Participants | 10 Participants |
| History of hormonal therapy (HT) None | 12 Participants | 29 Participants | 17 Participants |
| History of hormonal therapy (HT) Prior HT | 5 Participants | 8 Participants | 3 Participants |
| Hypercoagulable states | 1 Participants | 1 Participants | 0 Participants |
| Hypertension (HTN) | 9 Participants | 19 Participants | 10 Participants |
| Immunosuppressive medications | 1 Participants | 2 Participants | 1 Participants |
| Prior chemotherapy | 10 Participants | 20 Participants | 10 Participants |
| Prior radiation | 6 Participants | 16 Participants | 10 Participants |
| Race and Ethnicity Not Collected | — | 0 Participants | — |
| Sex: Female, Male Female | 30 Participants | 60 Participants | 30 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
| Smoker | 1 Participants | 1 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 30 | 0 / 30 |
| other Total, other adverse events | 0 / 30 | 0 / 30 |
| serious Total, serious adverse events | 0 / 30 | 0 / 30 |
Outcome results
Primary
Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME)
Amount of supplemental postoperative narcotic analgesia (both intravenous and oral) required by study groups in oral morphine equivalents
Time frame: Postoperative day (POD) 1 to 7
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 3 | 12.2 mg morphine equivalents | Standard Deviation 15.3 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 5 | 7.33 mg morphine equivalents | Standard Deviation 8.48 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 2 | 20.7 mg morphine equivalents | Standard Deviation 20.5 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 6 | 5.1 mg morphine equivalents | Standard Deviation 7 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 4 | 8.2 mg morphine equivalents | Standard Deviation 8.7 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 7 | 3.8 mg morphine equivalents | Standard Deviation 5.9 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 1 | 19.8 mg morphine equivalents | Standard Deviation 18.8 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 7 | 4.9 mg morphine equivalents | Standard Deviation 7.7 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 1 | 23.6 mg morphine equivalents | Standard Deviation 17.5 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 2 | 25.2 mg morphine equivalents | Standard Deviation 23.5 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 3 | 12.8 mg morphine equivalents | Standard Deviation 11.7 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 4 | 8.8 mg morphine equivalents | Standard Deviation 9.3 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 5 | 6.52 mg morphine equivalents | Standard Deviation 8.51 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Amount of Supplemental Postoperative Narcotic Analgesia in Oral Morphine Equivalents (OME) | POD 6 | 6.8 mg morphine equivalents | Standard Deviation 7.7 |
Secondary
Ambulation
Time to first ambulate post op (in days)
Time frame: 1 day post op
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Ambulation | 1 days | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Ambulation | 1 days | Standard Deviation 0 |
Secondary
Length of Stay
Length of hospital stay post operatively
Time frame: 1 to 4 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Length of Stay | 2.43 DAYS | Standard Deviation 0.77 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Length of Stay | 2.23 DAYS | Standard Deviation 0.43 |
Secondary
Non-narcotic Pain Medication Intake: Acetaminophen
The total use of the non-narcotic pain medication Acetaminophen was recorded during hospitalization
Time frame: Post op day 1 to 7
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 4 | 1937 milligrams | Standard Deviation 1239 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 1 | 2630 milligrams | Standard Deviation 803 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 3 | 2160 milligrams | Standard Deviation 1334 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 6 | 1903 milligrams | Standard Deviation 1179 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 5 | 1757 milligrams | Standard Deviation 1159 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 7 | 1887 milligrams | Standard Deviation 1174 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 2 | 2937 milligrams | Standard Deviation 972 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 7 | 1588 milligrams | Standard Deviation 1171 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 2 | 2868 milligrams | Standard Deviation 799 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 3 | 1945 milligrams | Standard Deviation 1342 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 4 | 1722 milligrams | Standard Deviation 116 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 5 | 1755 milligrams | Standard Deviation 1130 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 1 | 2840 milligrams | Standard Deviation 503 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non-narcotic Pain Medication Intake: Acetaminophen | POD 6 | 1755 milligrams | Standard Deviation 1067 |
Secondary
Non Narcotic Pain Medication Intake: Celebrex
The total use of the non-narcotic pain medication celebrex was recorded during hospitalization
Time frame: post op day 1 to 7
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 2 | 193 milligrams | Standard Deviation 146 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 4 | 20 milligrams | Standard Deviation 61 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 1 | 200 milligrams | Standard Deviation 144 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 5 | 20 milligrams | Standard Deviation 61 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 3 | 67 milligrams | Standard Deviation 132 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 6 | 13 milligrams | Standard Deviation 51 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 7 | 13 milligrams | Standard Deviation 51 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 6 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 7 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 1 | 187 milligrams | Standard Deviation 138 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 2 | 203 milligrams | Standard Deviation 119 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 3 | 60 milligrams | Standard Deviation 113 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 4 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Celebrex | POD 5 | 0 milligrams | Standard Deviation 0 |
Secondary
Non Narcotic Pain Medication Intake: Cyclobenzaprine
The total use of the non-narcotic pain medication Cyclobenzaprine was recorded during hospitalization
Time frame: Post op day 1 to 7
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 3 | 2.5 milligrams | Standard Deviation 4.9 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 5 | 3.7 milligrams | Standard Deviation 7.2 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 1 | 0.5 milligrams | Standard Deviation 1.5 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 6 | 4 milligrams | Standard Deviation 8.3 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 2 | 2 milligrams | Standard Deviation 4.3 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 7 | 3 milligrams | Standard Deviation 6.8 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 4 | 3.7 milligrams | Standard Deviation 8.1 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 7 | 2.2 milligrams | Standard Deviation 5 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 2 | 1.2 milligrams | Standard Deviation 4.1 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 3 | 1.5 milligrams | Standard Deviation 4.4 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 4 | 1.7 milligrams | Standard Deviation 4.8 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 5 | 1.8 milligrams | Standard Deviation 4.8 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 6 | 1.8 milligrams | Standard Deviation 4.8 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Cyclobenzaprine | POD 1 | 1.2 milligrams | Standard Deviation 5.5 |
Secondary
Non Narcotic Pain Medication Intake: Gabapentin
The total use of the non-narcotic pain medication gabapentin was recorded during hospitalization
Time frame: Post op day 1 to 7
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 5 | 537 milligrams | Standard Deviation 451 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 3 | 680 milligrams | Standard Deviation 489 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 1 | 730 milligrams | Standard Deviation 315 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 6 | 503 milligrams | Standard Deviation 453 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 4 | 603 milligrams | Standard Deviation 454 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 7 | 457 milligrams | Standard Deviation 449 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 2 | 807 milligrams | Standard Deviation 358 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 7 | 527 milligrams | Standard Deviation 445 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 4 | 517 milligrams | Standard Deviation 371 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 1 | 750 milligrams | Standard Deviation 298 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 2 | 813 milligrams | Standard Deviation 356 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 5 | 583 milligrams | Standard Deviation 397 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 6 | 560 milligrams | Standard Deviation 443 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Gabapentin | POD 3 | 577 milligrams | Standard Deviation 378 |
Secondary
Non Narcotic Pain Medication Intake: Ondansetron
The total use of the non-narcotic pain medication ondansetron was recorded during hospitalization
Time frame: Post op day 1 to 7
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 3 | 0.27 milligrams | Standard Deviation 1.46 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 5 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 2 | 0.4 milligrams | Standard Deviation 1.6 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 6 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 4 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 7 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 1 | 1.3 milligrams | Standard Deviation 2.6 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 7 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 1 | 2.3 milligrams | Standard Deviation 3.3 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 2 | 0.4 milligrams | Standard Deviation 1.2 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 3 | 0.27 milligrams | Standard Deviation 1.01 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 4 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 5 | 0 milligrams | Standard Deviation 0 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Non Narcotic Pain Medication Intake: Ondansetron | POD 6 | 0 milligrams | Standard Deviation 0 |
Secondary
Pain Measure
Pain as measured by numeric rating scale ranging from 0 (no pain) to 10 (worst pain ever).
Time frame: Post operative day (POD) 1 to 7
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Pain Measure | POD 3 | 2.9 score on a scale | Standard Deviation 2.3 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Pain Measure | POD 5 | 2.6 score on a scale | Standard Deviation 2.2 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Pain Measure | POD 2 | 2 score on a scale | Standard Deviation 1.7 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Pain Measure | POD 6 | 2.3 score on a scale | Standard Deviation 2.1 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Pain Measure | POD 4 | 2.9 score on a scale | Standard Deviation 2.2 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Pain Measure | POD 7 | 2.3 score on a scale | Standard Deviation 2.3 |
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Pain Measure | POD 1 | 2.43 score on a scale | Standard Deviation 1.98 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Pain Measure | POD 7 | 2.8 score on a scale | Standard Deviation 2.5 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Pain Measure | POD 1 | 2.93 score on a scale | Standard Deviation 2.8 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Pain Measure | POD 2 | 3.1 score on a scale | Standard Deviation 3 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Pain Measure | POD 3 | 3.1 score on a scale | Standard Deviation 2.5 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Pain Measure | POD 4 | 3.1 score on a scale | Standard Deviation 2.7 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Pain Measure | POD 5 | 3.1 score on a scale | Standard Deviation 2.6 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Pain Measure | POD 6 | 3.2 score on a scale | Standard Deviation 2.7 |
Secondary
Time to First Opiate Use
Time from end of surgery to time of first opioid intake measured in hours
Time frame: 0-29.8 hours post operation
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Time to First Opiate Use | 12.4 hours | Standard Deviation 17.4 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Time to First Opiate Use | 8.2 hours | Standard Deviation 19.8 |
Secondary
Time to Return of Bowel Function
Mean time in days at which patients had a return of bowel movement post op
Time frame: 1 to 4 days post operation
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Transversus Abdominis Plane (TAP) Block With Liposomal Bupivacaine | Time to Return of Bowel Function | 2.62 days | Standard Deviation 0.97 |
| Transversus Abdominis Plane (TAP) Block With Regular Bupivacaine | Time to Return of Bowel Function | 2.58 days | Standard Deviation 0.97 |