Bupivacaine/Epinephrine +Dexamethasone vs. Liposomal Bupivacaine

Title of Project: Liposomal Bupivacaine (Exparel) Versus Bupivacaine And Dexamethasone Intercostal Nerve Blocks For Robotic Thoracic Surgery: A Prospective Randomized Single-Blinded Clinical Trial

This study will assess analgesia after robotic lung surgery. Subjects will be randomized to receive wound infiltration and intercostal nerve block with either liposomal bupivacaine or bupivacaine/epinephrine + dexamethasone. Liposomal bupivacaine is a newer local anesthetic product and has not been compared to a combination of bupivacaine/epinephrine + dexamethasone in the context of pain control after robotic lung surgery.

Inclusion Criteria:

• undergoing robotic wedge resection or lobectomy for lung mass(es)

Exclusion Criteria:

• emergency case
• history of opiate abuse
• chronic pain syndrome
• intravenous drug use
• chronic use of oral steroids
• pregnancy
• imprisonment
• body weight lower than 70 kg
• liver failure
• uninsured patients
• non-verbal patients or patients who are unable to rate their pain on a visual analogue pain scale
• history of allergic reaction to any of the drugs used in the study: bupivacaine, liposomal bupivacaine, dexamethasone