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Ultrasound‐guided subcostal transversus abdominis plane blocks with liposomal bupivacaine vs. non‐liposomal bupivacaine for postoperative pain control after laparoscopic hand‐assisted donor nephrectomy: a prospective randomised observer‐blinded study
Author(s) -
Hutchins J. L.,
Kesha R.,
Blanco F.,
Dunn T.,
Hochhalter R.
Publication year - 2016
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13502
Subject(s) - medicine , bupivacaine , anesthesia , saline , fentanyl , nephrectomy , surgery , local anesthetic , kidney
Summary We compared the effect of subcostal transversus abdominis plane ( TAP ) block with liposomal bupivacaine to TAP block with non‐liposomal bupivacaine on postoperative maximal pain scores in patients undergoing donor nephrectomy. Sixty patients were prospectively randomly assigned to receive ultrasound‐guided bilateral TAP s with either 1.3% liposomal bupivacaine and normal saline or 0.25% non‐liposomal bupivacaine with adrenaline. There was a significant decrease in maximal pain scores in the liposomal bupivacaine TAP group when compared with the non‐liposomal bupivacaine group median ( IQR [range]), 24–48 h after injection, 5 (3.0–5.2 [0–10]) vs. 6 (4.5–7.0 [1––9]) p = 0.009; 48–72 h after injection, 3 (2.0–5.0 [0–8]) vs. 5 (3.0–7.0 [0–10]) p = 0.02; and in opioid use 48–72 h after injection, mean ( SD ) μg equivalents of fentanyl 105 (97) vs. 182 (162) p = 0.03. Liposomal bupivacaine via subcostal TAP infiltration provided superior analgesia up to 72 h after injection when compared with non‐liposomal bupivacaine.