• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

TRANSVERSUS ABDOMINIS BLOCK UTILIZING LIPOSOMAL BUPIVACAINE AS A NON-OPIOD ANALGESIC FOR POST-OP PAIN MANAGEMENT

Thomas C Robertson, MD1, Kathryn Hall2, Susan Bear, PharmD1, Kyle Thompson, PhD1, Keith Gersin, MD1. 1Carolinas Medical Center, 2Virginia Tech

Introduction: Opioid-related deaths now outnumber vehicle-related deaths in the United States. The trajectory of opioid addiction usually begins with prescription opioid misuse. Identifying non-narcotic means to treat post-op pain is an intervention to limit patient exposure to opioids. The objectives of this study were to compare the effectiveness of a liposomal bupivacaine transverse abdominis plane (TAP) block to opioid-only patient controlled anesthesia (PCA) pain management in respect to total morphine equivalents received, lengths of stay, and post-operative pain scores following bariatric surgery.

Methods and Procedures: A single surgeon retrospective chart review was performed on 440 patients who underwent laparoscopic roux-en-y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (Sleeve) from 2010-2016. Patients were grouped according to those who received TAP blocks immediately pre-operatively and those who received PCA only. Total parenteral morphine equivalents (PME) were calculated for each patient. Pain scores were calculated immediately following surgery, 12 hours post-operatively, and on day of discharge. Median length of stay (LOS) and 30-day readmissions were determined. 

Results: Patients with PCA pain management utilized more narcotics following RYGB (70.4±2.7 PME) and Sleeve (60.0±3.5) than those treated with pre-operative TAP block (26.5±1.5 and 24.1±2.0 PME) for RYGB and Sleeve respectively (p < .0001). Median LOS was 2.0 days for both PCA groups whereas LOS decreased to 1.0 day for both groups of patients receiving TAP blocks (p < .0001). 30-day readmissions were 7.5% (RYGB) and 4.9%(Sleeve) for PCA patients versus 6.6% (RYGB) and 0.95% (Sleeve) for TAP block patients (p = .1213). Pain scores immediately after surgery, 12 hours after surgery and prior to discharge were unchanged for PCA versus TAP block for both RYGB and Sleeve patients.

Conclusions: TAP blocks with liposomal bupivacaine lead to significantly less use of parenteral morphine equivalents. Length of stay is significantly less for patients who received a TAP block. Morbidly obese patients receiving liposomal bupivacaine TAP blocks have equivalent pain control and decreased length of stay compared to PCA alone.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 85263

Program Number: S089

Presentation Session: Plenary 1 Session

Presentation Type: Podium

54

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2024 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons