Analgesic Efficacy of Liposomal Bupivacaine vs. Bupivacaine HCL as a Tap Block After Abdominally Based Autologous Breast Reconstruction

A Prospective Trial to Assess Analgesic Efficacy of Liposomal Bupivacaine vs. Bupivacaine HCL as a Tap Block After Abdominally Based Autologous Breast Reconstruction

This study will evaluate the efficacy of analgesia provided by liposomal bupivacaine (Exparel) when compared to bupivacaine HCL as a transverse abdominis plane (TAP) block in terms of discharge milestones, opioid use, costs, and patient-reported satisfaction at 12, 24, and 72 hours. The investigators propose that Exparel will lower opioid use, length of stay, and overall cost of abdominally-based autologous breast reconstruction, and will lead to greater patient satisfaction.

Inclusion Criteria:

• Scheduled for abdominal-based autologous breast reconstruction (DIEP, MS-TRAM, or TRAM).
• At least 18 years of age.
• Female.
• Able to understand and willing to sign a written informed consent document.

Exclusion Criteria:

• Cognitive impairment.
• History of abdominal surgery precluding free flap donor site.
• Allergy or intolerance to bupivacaine or "amide" anesthetics.
• Significant preoperative chronic pain (requiring daily narcotics) or neuropathic pain (requiring daily use of pregabalin or gabapentin) within the previous 3 months.
• Pregnant or breastfeeding.