For a study, researchers sought to know the efficacy of liposomal bupivacaine on postoperative opioid needs and pain following abdominal wall reconstruction. Despite the huge usage of liposomal bupivacaine in transversus abdominis plane block, there was inadequate evidence demonstrating its importance in open abdominal wall reconstruction. Investigators hypothesized that liposomal bupivacaine plane block would have resulted in decreased opioid needs differentiated with placebo in the first 72 hours after surgery. Adult patients (at least 18 yrs of age) undergoing open, elective, ventral hernia repairs were randomized to surgeon-performed transversus abdominis plane block with liposomal bupivacaine, simple bupivacaine, or normal saline (placebo). The main result was opioid needs in the first 72 hours after surgery. Secondary results involved total inpatient opioid use, pain scores determined utilizing a 100 mm visual analog scale, length of hospital stay, and patient-reported quality of life. Of the 164 patients who were included in the analysis, 57 patients received liposomal bupivacaine, 55 patients received simple bupivacaine, and 52 received placebo. There were no variations in the total opioid utilized in the first 72 hours after surgery as evaluated by morphine milligram equivalents when liposomal bupivacaine was differentiated with simple bupivacaine and placebo (325±225 vs. 350±284 vs. 310±272, respectively, P=0.725). Similarly, there were no variations in all the inpatient opioid utilization, pain scores, length of stay, and patient-reported quality of life. There were no apparent clinical benefits to utilizing liposomal bupivacaine transversus abdominis plane block when differentiated with simple bupivacaine and placebo for open abdominal wall reconstruction.
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