Tran JP, Padilla PL, McLaughlin J, Aliano KA, Doan M and Phillips LG*
Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Texas Medical Branch, USAFulltext PDF
Background: Pain management is particularly important in massive weight loss patients undergoing abdominoplasty. In the setting of abdominoplasty, patients usually require multi-modal analgesia to achieve adequate pain control. Liposomal bupivacaine, marketed as Exparel, and the continuous local anesthetic infusion pump, or On-Q pump, are two pain control modalities often used after body contouring procedures.Objective: The purpose of this study was to compare the effectiveness of Exparel with the On-Q pump following abdominal body contouring procedures in massive weight loss patients.Methods: A retrospective chart review was performed on all massive weight loss patients who underwent a variety of body contouring procedures, including fleur-de-Lis abdominoplasty, belt lipectomy, abdominoplasty, and combined belt lipectomy at a single institution between 2009-2014. Demographics, preoperative laboratory studies, procedure report, and 0-48 hour post-procedure assessment logs were reviewed for the study.Results: Fifty-seven patients were included in the study. Forty-five patients received Exparel for postoperative pain control and twelve received the On-Q pump. The results demonstrate that opioid requirements for the Exparel group were significantly less than the On-Q group from 0-12 hours and from 12-24 hours.Conclusions: Our study demonstrates that patients who received Exparel had lower requirements for postoperative opiates than those who received the On-Q pump. The data showed that a singledose local infiltrative injection of Exparel is superior to the continuous bupivacaine pump infusion for pain control. Based on patient reported pain scores, Exparel was superior to bupivacaine pump at improving patient comfort within the first 12 hours postop.
Liposomal bupivacaine; Massive weight loss; Abdominoplasty; Body contouring
Tran JP, Padilla PL, McLaughlin J, Aliano KA, Doan M, Phillips LG. Comparative Analysis of Intraoperative use of Liposomal Bupivacaine (Exparel) and ON-Q Pump for Postoperative Analgesia in Abdominal Body Contouring Surgery in Massive Weight Loss Patients. Clin Surg. 2016; 1: 1080.