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CLINICAL PHARMACOLOGY
Year : 2020  |  Volume : 36  |  Issue : 1  |  Page : 110-114

The use of extended release bupivacaine with transversus abdominis plane and subcostal anterior quadratus lumborum catheters: A retrospective analysis of a novel technique

Hesham Elsharkawy1, Wael Saasouh2, Yoon Jeong Cho3, Loran Mounir Soliman3, Jean-Louis Horn4
1 Case Western Reserve University; Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, USA
2 Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH; Department of Anaesthesiology, Detroit Medical Centre, Detroit, MI, USA
3 Department of General Anaesthesiology, Cleveland Clinic, Cleveland, OH, USA
4 Department of Anaesthesiology, Stanford University, Stanford, CA, USA

Correspondence Address:
Dr. Hesham Elsharkawy
Associate Professor, Case Western Reserve University, Department of Outcomes Research, Anaesthesiology Institute, Cleveland Clinic, OH
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joacp.JOACP_358_18

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Background and Aims: Liposomal bupivacaine (LB) is a formulation of local anesthetic that may exert analgesia over a prolonged period. Anecdotal use of LB suggests benefit and prolonged analgesia when used to supplement infiltration blocks. Our aim was to test the effect of a bolus of LB delivered through a nerve catheter in two types of interfascial plane blocks (transversus abdominis plane and anterior subcostal quadratus lumborum). The effect was evaluated through patient self-reporting of postsurgical pain up to 48 postoperative hours. Material and Methods: Medical records of adult postoperative patients who received LB in a peripheral nerve catheter were followed retrospectively and analysed for pain scores and spread of dermatomal numbness over 48 h following the postoperative dose. A chart review of patients who qualified between June 2015 and March 2017 was performed, and clinical data were obtained from the institutional Perioperative Health Documentation System. Results: Pain scores decreased following LB bolus, and all patients reported efficient block analgesia after bolus injection. Dermatomal numbness decreased gradually and was minimal by 48 h following bolus. Conclusion: LB can be injected through a peripheral nerve catheter to prolong analgesia after catheter removal.


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