Post-Operative Pain Control: A Retrospective Study Investigating the Impact of Anesthetic Choice for TAP block [2R]. (May 2018)

• Record Type: Journal Article
• Authors: Morrison, Christopher; Schuler, Kevin; Devaiah, Ganga; Maetzold, Erin; Crisp, Catrina
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000533252.02949.97
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Transversus abdominis plane (TAP) block has been shown to decrease narcotic requirements, lower pain scores, and decrease length of hospital stay in the post-operative setting. Variation exists regarding choice of anesthetic agent used to perform the block. We investigate the impact of anesthetic choice on TAP block in gynecologic oncology patients undergoing laparotomy via midline vertical incision. METHODS: This is a retrospective cohort study involving 70 patients from a large academic referral center from 2014-2017 undergoing TAP block for perioperative pain control. Subjects received either bupivacaine or liposomal bupivacaine for TAP. Narcotic use for post-operative day 0-3 was the primary outcome, with post-operative pain scores and hospital length of stay as secondary outcomes. RESULTS: Average age was 56 years with the bupivacaine group being older: 58 vs. 52 years (p=0.012). No significant differences were found among post-operative narcotic requirements. Pain scores at regular intervals up to 72 hours between groups were also not different. When analyzing timing of the TAP, there was no difference in narcotic requirements or pain scores when the TAP was performed before or after the surgical procedure. Lastly, choice of anesthetic did not impact hospital length of stay. CONCLUSION: No significant differences were found between bupivacaine and liposomal bupivacaine with regard to post-operative narcotic requirements, pain scores, or length of hospital stay in gynecologic oncology patients undergoing laparotomy. A prospective approach to investigate anesthetic choice and timing would be needed in order to better investigate timing and anesthetic choice.