Tap

Randomized controlled study of transversus abdominis plane blocks for postoperative pain control following major open abdominal procedures

Tap

Description: The main goal of the current study is as follows: to determine the correlation between pain management using a continuous infusion of local anesthetics via a transversus abdominis plane block in colon surgery patients and pain outcomes vs. a single injection of local anesthetic either ropivacaine or liposomal encapsulated bupivacaine into the transversus abdominus plane.  In selecting this goal, we hope to gain a better understanding of the use of a transversus abdominis plane blocks in pain control strategies and improvement of the quality of care.

Device: I-Flow device

Primary Investigator: Vaughan

Drug/Device Information
Pain management using a continuous infusion of local anesthetics via a transversus abdominis plane (TAP) block and pain outcomes vs. a single injection of local anesthetic into the TAP
(TAP) transversus abdominus plane
Ultrasound guided continuous TAP blocks (CTAP) with a local anesthetic
Randomized 1:1:1
Arm 1 - CTAP via commercially available ON-Q pain management system filled with 0.2% ropivacaine with a loading dose of 30ml 0.5% ropivacaine per side will be given at catheter placement
Arm - 2 commercially available ON-Q pain management system filled with saline and a loading dose of 30ml 0.5% ropivacaine per side will be given at the time of catheter placement
Arm - 3 a single injection of ropivacaine (0.5% 60 ml divided into two doses for bilateral use)
Arm - 3 continued or liposomal encapsulated bupivacaine (266 mg diluted to 60 ml, 20cc Exparel, 40cc normal saline divided into two doses for bilateral use) into the TAP plane
Dr. Vaughan
Major Inclusion and Exclusion
Scheduled for open or laparoscopic hand assisted abdominal surgery
Minimum weight of 60 kg and no BMI > 40
No chronic Opioid use as defined as daily consumption of opioids for greater than 3 months preoperative
No contraindication to regional nerve block (bleeding disorder, infection at site of block)