Pain control in bariatric patients: A Prospective trial comparing the effectiveness of Exparel versus the on Q pain ball

Franchell Richard, MD, Terive Duperier, MD

Univeristy of Texas Health Science Center in Houston at Bariatric Medical Institute

Background: The purpose of this study is to compare the effectiveness of the On Q pain ball to Exparel for pain control at extraction and stapler insertion sites in our bariatric patients The most common site post-operatively for bariatric patients is the gastrectomy extraction site and the site where the intraluminal stapler is inserted for those patients undergoing a gastric bypass. Pain limits post-operative mobility and incentive spirometer use leading to multiple negative effects such as atelectasis and pneumonia. Because the extraction site and the intra-luminal stapler insertion site requires a larger incision, often with stretching of the muscle and sutures to close the fascia, our center has focused on obtaining better pain control.

Methods: All patients undergoing laparoscopic sleeve gastrectomy (SG) and roux n Y gastric bypass (RGB) will be followed prospectively to evaluate postoperative pain utilizing the Numeric Rating Scale (NRS; 0= no pain and 10=worst pain). Pain will be assessed subjectively by the NRS. Objectively pain will be assessed by physical examination by looking at amount of narcotics used while in the hospital and during the first post-operative week.

Results: Currently nineteen patients in the On Q pain ball group had an average pain scale of 7 while 16 patients in the Exparel group had an average pain score of 3 post-operatively. Patients in the Exparel pain group used less narcotic medication in the hospital and one week post-operatively. This research is currently ongoing with more patients enrolled and will be complete by time of presentation.

Conclusion: Exparel appears to be superior to the On Q pain ball when it comes to pain control in bariatric procedures


Session: Poster Presentation

Program Number: P423

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