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Updated: Oct 2, 2025

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

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Published on: June 25, 2013

Transversus abdominis plane blocks for complex abdominal wall reconstruction decrease hospital length of stay

Nicole L Petcka¹, Katie Alter-Troilo¹, Emily Hetzel¹

¹Division of Minimally Invasive and Gastrointestinal Surgery, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA.

Surgical Endoscopy

|February 23, 2022

Summary

This summary is machine-generated.

Transversus abdominis plane (TAP) blocks with liposomal bupivacaine can reduce length of stay for complex ventral hernia repair patients. While pain scores may be higher initially, TAP blocks offer a viable alternative to epidurals for post-operative pain management.

Keywords:

Liposomal bupivacaine Transversus abdominis plane blocks Ventral hernia repair

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Area of Science:

Abdominal surgery
Pain management
Hernia repair

Background:

Complex abdominal wall reconstruction for ventral and incisional hernias often involves significant post-operative pain and prolonged hospital stays.
Current pain management strategies include epidural catheters, transversus abdominis plane (TAP) blocks, and intravenous narcotic pain medications (IVPM).

Purpose of the Study:

To investigate whether TAP blocks with liposomal bupivacaine reduce length of stay (LOS) compared to epidurals and IVPM after ventral hernia repair.
To evaluate the impact of different pain management techniques on post-operative pain and complications.

Main Methods:

A retrospective review of patients undergoing open ventral hernia repair with retromuscular mesh between 2016 and 2020.
Primary outcome was length of stay (LOS); secondary outcomes included post-operative pain scores and 90-day complications.

Main Results:

The TAP block group (18 patients) had a significantly shorter LOS (4.22 days) compared to the epidural group (66 patients, 5.62 days).
The epidural group had longer surgery duration and larger mesh area than the TAP block group.
The epidural group reported lower post-operative day one pain scores than the TAP block and IVPM groups, but no significant difference in complications was observed between groups.

Conclusions:

TAP blocks with liposomal bupivacaine are associated with a shorter length of stay in complex ventral hernia repairs compared to epidurals.
Despite potentially higher initial pain scores, TAP blocks offer a safe and effective option for post-operative pain control, with no increase in complications.