Comparison of Liposomal Bupivacaine, Plain Bupivacaine, and Placebo for Transversus Abdominis Plane Blocks: A Randomized, Blinded Trial

• Applicant: Dr. Carolin Müller
• Subject Area: Anaesthesiology ; Gynaecology and Obstetrics
• Term: since 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 498537330

Pain management after major abdominal surgery remains challenging. The best-accepted traditional analgesic approach is continuous epidural analgesia. An alternative is the transversus abdominis plane (TAP) block. As single injection or continuous local anesthetic infusion over a catheter, TAP blocks provide good analgesia and are easy to perform. In contrast to epidural analgesia, they can also be performed in anti-coagulated patients. Administered as a single shot, catheter-related complications as infection, hematoma, or dislodgement cannot occur. Single shot plain bupivacaine is often used for TAP blocks, but plain bupivacaine provides less than 24 hours of analgesia. Catheters provide analgesia for longer, but they are difficult to position properly and difficult to maintain in the proper anatomical location. Encapsulated bupivacaine (=liposomal bupivacaine) might prolong the duration of action up to 3 days and can be applied as a single shot. There are some randomized, controlled trials published that investigated the use of liposomal bupivacaine in TAP-blocks, but the prolonged duration of analgesia and the superiority of liposomal bupivacaine compared to other analgesics remains controversial. We therefore primarily aim to compare the duration of abdominal wall analgesia (determined by pinprick and cold) following a single-shot TAP infiltration with liposomal bupivacaine, plain bupivacaine, and placebo after abdominal surgery over 72 hours, or the duration of hospitalization if shorter. Additionally, we aim to compare pain, opioid consumption, opioid-related side effects, patient satisfaction, and costs of hospital care.

• DFG Programme: WBP Fellowship
• International Connection: USA
• Host: Professor Dr. Daniel I. Sessler