title: Ultrasound-guided subcostal transversus abdominis plane infiltration with liposomal bupivacaine for patients undergoing robotic-assisted hysterectomy: a retrospective study.
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.
authors: *Department of Anesthesiology, †Masonic Cancer Center Biostatistics and Bioinformatics, and ‡Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN.
authors: Jacob
authors: J
authors: Hutchins
authors: Rachel Isaksson
authors: RI
authors: Vogel
authors: Rahel
authors: R
authors: Ghebre
authors: Amy
authors: A
authors: McNally
authors: Levi S
authors: LS
authors: Downs
authors: Elizabeth
authors: E
authors: Gryzmala
authors: Melissa A
authors: MA
authors: Geller
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging / Q000601:surgery*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010535:Laparoscopy; D007902:Length of Stay; D008081:Liposomes; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011379:Prognosis; D012189:Retrospective Studies; D012371:Robotics; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D008081:Liposomes; D002045:Bupivacaine