title: 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.
abstract: 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 TAPs 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.
authors.affiliation: Department of Anaesthesiology, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Hutchins
authors.affiliation: Department of Anaesthesiology, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: R
authors.initials: R
authors.lastname: Kesha
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: F
authors.initials: F
authors.lastname: Blanco
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: T
authors.initials: T
authors.lastname: Dunn
authors.affiliation: Department of Anaesthesiology, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: R
authors.initials: R
authors.lastname: Hochhalter
mesh_terms: D000009:Abdominal Muscles / Q000294:innervation*; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D014019:Tissue Donors; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine
keywords: donor nephrectomy; liposomal bupivacaine; transversus abdominis plane block