Gynecologic Oncology Robotic-Assisted Hysterectomy: Medical center in Minnesota
Study Methods
- 60 adult patients undergoing robotic-assisted hysterectomy: 30 received a transversus abdominis plane block with EXPAREL, and 30 did not receive a TAP block
- Retrospective observational study
- All patients received intraoperative and postsurgical opioids
Safety Outcomes
- 3.3% of patients in the TAP block EXPAREL group had a postsurgical complication, compared with 20% in the group of patients who did not receive a TAP block
Clinical and Economic Outcomes
In patients who received EXPAREL for analgesia
Significantly
less pain
(P=0.05)
over first 24 hours after infiltration- 5 vs 7 on 11-point scale*
16.2 hours
shorter LOS
- 11.5 vs 27.7 hours (P>0.0001)
63%
fewer occurrences
of nausea or
vomiting- 20% vs 53.3% (P=0.02)
HYSTERECTOMY WITHOUT TAP BLOCK (n=30)
- Intraoperative and postsurgical opioid-based analgesia regimen
HYSTERECTOMY WITH TAP BLOCK AND EXPAREL (n=30)
- Intraoperative and postsurgical opioid-based analgesia regimen
- A subcostal TAP block was performed under ultrasound guidance with a 22-gauge 30º beveled needle. After the needle pierced the transversus abdominis fascia, three 10-mL syringes of local anesthetic were injected. The first syringe contained 10 mL of 0.25% bupivacaine with epinephrine (1:200,000), and the other 2 syringes each contained 5 mL of EXPAREL and 5 mL of 0.9% preservative-free normal saline†
- This process was repeated on the contralateral side
*Difference in pain scores remained statistically significant after adjustments for potential confounders (P=0.004).
†The use of EXPAREL in combination with epinephrine is not part of the approved label.
TAP, transversus abdominis plane; LOS, length of stay.