Hernia Abd Wall Recons - BDE vs Exparel

Comparative Effectiveness of Bupivacaine-Dexamethasone-Epinephrine Versus Exparel in Postoperative Outcomes for Hernia Patients Undergoing Abdominal Wall Reconstruction

This trial compares how two different numbing medications help patients feel the least amount of pain while recovering from surgery.

This will be a prospective randomized controlled trial comparing the outcomes of hernia patients receiving BDE versus Exparel before abdominal wall reconstruction. The study will utilize the pain numeric rating scale (PNRS) validated questionnaire to assess pain levels. Patients will be asked to report their worst pain imaginable.

Inclusion Criteria:

• Any preoperative robotic and open abdominal wall surgery patient who will receive a transversus Abdominis Plane (TAP) block in the BSW health care system who agrees to participate in the study
• Patients 18 years and above

Exclusion Criteria:

• Patients not undergoing abdominal wall reconstruction surgery
• Pregnant patients- Patients with childbearing potential undergo serum pregnancy test as per standard of care pre-procedure. If they are found to test positive, they will be excluded from the study.
• Patients less than 18 years old
• Patients receiving any additional regional anesthesia outside the study protocol prior to surgery.
• Patients undergoing additional planned surgical procedures during the same admission
• History of chronic pain or chronic opioid use Known allergy to BDE or Exparel or to drugs included as part of multimodal regimen { acetaminophen, gabapentin or Lyrica (pregabalin)}.