Abdominally Based Microsurgical Breast Reconstruction: Medical center in New York
- 128 adult patients undergoing breast reconstruction using abdominally based free flaps with or without a non-narcotic protocol using intraoperative TAP blockade. Patients were divided into a control group, a TAP catheter group, and a TAP EXPAREL group
- Retrospective observational study
- Primary and secondary outcomes were assessed for associations and adjusted for confounding variables
- The overall complication rate was 8.7%, with no significant differences between the groups
- The TAP catheter group noted higher rates of transfusions (P=0.0084)
Clinical and Economic Outcomes
In patients who received EXPAREL for analgesia
Fewer total opioids used
after surgery vs catheter and control groups (mg)*†
- Day 0–1: 1.88 vs 7.25 (P=0.0081) vs 52.86 (P<0.0001)
- Day 2: 2.12 vs 5.17 (P=0.0270) vs 29.9 (P=0.0009)
- EXPAREL group: 2.65 days
- TAP catheter group: 3.52 days
- Control group: 4.05 days
*Opioid consumption was measured using IV morphine equivalent (mg).
†The clinical benefit of the decrease in opioid consumption was not demonstrated in the clinical trials.
TAP, transversus abdominis plane.