Exparel Transversus Abdominis Plane Block vs Intrathecal Analgesia In Colorectal Surgery

Exparel Transversus Abdominis Plane Block vs Intrathecal Analgesia In Colorectal Surgery: A Prospective Randomized Trial

This study is prospective, randomized trial in which EXPAREL TAP block is compared to standard IT opioid administration, in relieving postoperative pain, decreasing length of stay, and use of narcotic medication.

Primary Objective To assess efficacy of EXPAREL TAP blocks in improving pain scores for 48 hours postoperatively, and in reducing total oral morphine equivalents (OME) use, compared to standard Intrathecal opioid administration (IT).

Secondary Objective Assess the length of stay (LOS), postoperative ileus (POI) incidence, and the use of intravenous patient controlled analgesia (PCA) in patients that had EXPAREL TAP blocs compared to IT.

Inclusion Criteria:

• • All patients undergoing elective laparoscopic or open colorectal resections who are eligible for IT

  • Age >18 years
  • BMI <40
  • Ability to understand and read English

Exclusion Criteria:

• • Not able or unwilling to sign consent.

  • Currently pregnant or lactating.
  • Patients with chronic pain, requiring daily opiate use at time of surgery.
  • Patients intolerant of opiates, NSAIDS, acetaminophen or local anesthetics.
  • Patients requiring emergent surgery.
  • Abdominoperineal resections
  • Any contraindications to neuraxial analgesia (coagulopathy, localized infection at the potential site of injection, pre-existing spinal canal pathology)
  • Patients with a diagnosis of inflammatory bowel disease