Ultrasound-guided subcostal transversus abdominis plane infiltration with liposomal bupivacaine for patients undergoing robotic-assisted hysterectomy: a retrospective study

Int J Gynecol Cancer. 2015 Jun;25(5):937-41. doi: 10.1097/IGC.0000000000000429.

Abstract

Objective: We sought to determine the effect of a subcostal transversus abdominis plane (TAP) block with liposomal bupivacaine on postoperative maximal pain score and length of hospital stay among women undergoing robotic-assisted hysterectomy.

Methods: This was a retrospective study comparing patients before and after consistent implementation of TAP blocks with liposomal bupivacaine during robotic-assisted hysterectomies at a single academic institution. Analysis compared patient demographic and operative characteristics by TAP block use, along with outcomes of interest, including postoperative pain and length of hospital stay.

Results: There was a statistically significant decrease in maximal numerical rating scale pain scores, presence of nausea and vomiting, and length of hospital stay in those who had a TAP block with liposomal bupivacaine compared with those who did not receive a TAP block. These differences remained even after adjustment for potential confounders.

Conclusions: In this retrospective study, liposomal bupivacaine used in a TAP block was a useful method to provide postoperative pain control in patients undergoing robotic-assisted hysterectomy and was associated with lower postoperative maximal pain scores and length of hospital stay.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Abdominal Muscles / diagnostic imaging
  • Abdominal Muscles / surgery*
  • Anesthetics, Local / administration & dosage
  • Bupivacaine / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Hysterectomy / adverse effects*
  • Laparoscopy
  • Length of Stay
  • Liposomes
  • Middle Aged
  • Nerve Block / methods*
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control*
  • Prognosis
  • Retrospective Studies
  • Robotics*
  • Ultrasonography, Interventional*

Substances

  • Anesthetics, Local
  • Liposomes
  • Bupivacaine