This study evaluates the use of regional abdominal block injections with liposomal bupivicaine in postoperative pain management in patients undergoing abdominoplasty with rectus plication.
Methods/Technique:
We preformed a retrospective review of 20 female patients who had undergone abdominoplasty with rectus plication. Patients received liposomal bupivicaine (Exparel) injections in an abdominal regional block fashion. Patient age, height, weight, and smoking status were recorded. Standardized postoperative intramuscular, intravenous injections and oral pain pills were recorded. Pain scores and activity level were evaluated at two postoperative visits.
Results/Complications:
The average number of procedures including abdominoplasty with rectus plication per case was eight. The average patient BMI was 27.6. The average first postoperative visit was four days after surgery. The average total oral pain pills required at the fist postoperative visit was 10.7, second postoperative visit was 11.5, and total postoperative was 21.65. The average pain score on postoperative visit one and two was 3.5, and 2.3 respectively. Two tailed student T-test showed a significant decrease in patient reported pain between postoperative visit one and two ( p = 0.009).
Conclusion:
Our experience with liposomal bupivicaine injections for regional blocks in abdominoplasty with plication indicate that patients require less postoperative narcotics, resume both earlier ambulation and normal activity. The simplicity of direct injection of long acting local anesthetic directly into the abdominal wall and the added benefit of decreased narcotic use suggest improved recovery with early resumption of normal activity and reduction of sequelae from oral pain medications. Further investigation is warranted with more clinical cases in order to recommend the use of this medication for routine pain management after an abdominoplasty.