Post Operative Pain Clinical Trial
Official title:
A Pilot Study: A Comparison of Liposomal Bupivacaine to Bupivacaine HCl in Transversus Abdominis Planus Block for Abdominal Gynecologic Surgery
This study evaluates the comparison between liposomal bupivacaine versus bupivacaine HCl in Transversus Abdominis Plane blocks for gynecologic surgery on the length of stay in the hospital, total narcotic use, and overall complications rates.
The proposed pilot study is evaluating the use of Exparel ™ in an anesthesia protocol for
patients undergoing major lower abdominal gynecologic surgery. Exparel ™ is a formulation of
liposomal bupivicaine that is reputed to have a much longer duration of action compares to
bupivacaine. Exparel™ has been originally demonstrated to be safe and effective in
bunionectomy and hemorrhoidectomy. It has recently gained FDA approval for all surgical site
infiltration including TAP (Transversus Abdominis Planus block) blocks. Exparel™ has also
been studied in other procedures and demonstrated reduction in opioid use and median length
of stay (LOS).
Currently, patients on the gynecologic oncology service undergoing major abdominal surgery
are receiving a type of regional anesthesia using bupivacaine HCl known as a TAP block as
part of an effort to decrease narcotic use post-operatively and decrease hospital length of
stay. Bupivacaine has a known eight to twelve hour duration of action, thus addressing
immediate post operative pain. As Exparel™ is anticipated to have a longer duration of
action, the purpose of this study is to determine if TAP blocks with Exparel™ have an
advantage over standard TAP blocks with bupivacaine HCl in reducing length of hospital stay
in a randomized controlled trial. Our hypothesis is that TAP blocks with Exparel™ will result
in reduced length of stay contributing to significant hospital cost savings. Secondary
outcomes include total narcotic use (hypothesized to be reduced) and overall complication
rates (hypothesized to remain unchanged). Given there are no published data on the efficacy
and safety of using Exparel™ in open gynecologic abdominal surgery, this will be a pilot
study.
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