Real-world insights on the use of transversus abdominis plane block with liposomal bupivacaine in the multimodal management of somatic versus visceral pain in the colorectal surgery setting
Nicholas C Connolly
Bend Anesthesiology Group, Bend, OR, USA
Multimodal approaches are recommended to achieve effective postsurgical analgesia with reduced opioid reliance and are integral to enhanced recovery after surgery (ERAS) protocols. Transversus abdominis plane (TAP) block is a regional analgesia technique commonly used in colorectal ERAS protocols, particularly in the laparoscopic surgery setting. Clinical trial data demonstrate TAP block with liposomal bupivacaine ([LB]; Exparel®, bupivacaine liposome injectable suspension; Pacira Pharmaceuticals, Inc., Parsippany, NJ, USA) to be an effective opioid-sparing approach for controlling pain after colorectal surgery. However, clinical trials poorly address patient factors that might affect outcomes using this approach. This editorial provides the author’s personal experience and opinions regarding the optimal use of LB in multimodal management of somatic versus visceral pain and in complex cases, including patients with ulcerative colitis (UC) or other intense visceral inflammatory processes.
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