Effectiveness of Exparel TAP Block in Breast Free Flap Reconstruction
Status:
Not yet recruiting
Trial end date:
2024-02-28
Target enrollment:
Participant gender:
Summary
Transversus Abdominis Plane (TAP) block is a useful tool in pain management after abdominal
surgery. It is a regional nerve block that targets T6-L1 thoracolumbar nerves running in the
plane between internal oblique and transversus abdominis muscle. It is shown to help with
post-operative pain management, reducing pain scores and narcotic pain medication use, as
well as promoting earlier return to activity and recovery. TAP block became a very popular,
safe, and effective therapeutic adjunct for many different abdominal surgeries ranging from
obstetric procedures to general surgery procedures like colorectal surgery. Furthermore, it
is used in plastic surgery procedures such as Deep Inferior Epigastric Perforator (DIEP) free
flap or Transverse Rectus Abdominis Myocutaneous (TRAM) flap, as they involve extensive
amount of abdominal soft tissue incision. Previous studies have shown that TAP block in these
procedures significantly reduce post-op pain and narcotic pain medication use. More recently,
Exparel (liposomal bupivacaine) has risen to spotlight for providing a longer, sustained
local anesthesia. Various surgical disciplines have adopted this agent as part of their pain
management protocol. However, there are no literatures that describe the effect of TAP block
using Exparel for breast free flap population. The study hypothesize that delivering TAP
block with Exparel (vs. plain bupivacaine) will provide longer regional blocking effect,
hence aiding in pain control and recovery postoperatively. The investigators will be
analyzing postop narcotic pain medication requirement and pain scores to look into this
question.