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Direct Transversus Abdominis Plane Blocks With Exparel During Abdominoplasty.

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This study shows that using liposomal bupivacaine for transversus abdominis plane (TAP) blocks during abdominoplasty significantly reduces early postoperative pain and opioid use. This technique offers improved pain management for patients recovering from abdominoplasty.

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Area of Science:

  • Plastic Surgery
  • Pain Management
  • Anesthesiology

Background:

  • Post-abdominoplasty pain control is a significant patient and surgeon concern.
  • Current standard treatments include pain pumps and opioid medications.
  • Liposomal bupivacaine offers a prolonged 72-hour duration of action for pain relief.

Purpose of the Study:

  • To evaluate the efficacy and safety of liposomal bupivacaine transversus abdominis plane (TAP) blocks during abdominoplasty.
  • To improve pain control in the early and intermediate recovery phases.
  • To assess the impact on opioid consumption and patient-reported pain scores.

Main Methods:

  • A pilot study involving 13 consecutive abdominoplasty patients.
  • Direct, fascial-splitting technique to access the TAP plane under direct vision.
  • Bilateral injection of 20 mL liposomal bupivacaine into the TAP plane.

Main Results:

  • Average Visual Analog Scale (VAS) pain scores were 2.5 on postoperative day 1 and 1.7 on postoperative day 3.
  • Average total opioid consumption was 7.5 tablets (75 mg) of oxycodone per patient.
  • All patients completed the study with adequate follow-up data.

Conclusions:

  • Liposomal bupivacaine TAP blocks performed under direct vision are safe and effective for abdominoplasty.
  • This technique demonstrates favorable pain control in the early and intermediate recovery periods.
  • Offers a promising approach to reduce postoperative pain after abdominoplasty.