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• W2743006806 abstract "Post-surgical analgesia can be addressed at numerous time points, from pre-operative “enhanced recovery protocols” to intra-operative nerve blocks or local infusion to post-operative narcotics. In order to address this short duration of local anesthetics, an indwelling pain pump can be utilized. However, pumps can become occluded and are not guaranteed to stay in the right anatomical plane. Thus, it would be ideal to provide a means of pain control that does not require external devices and that is desirable from a cost perspective. An intraoperative transversus abdominis plane (TAP) block can be utilized to anesthetize the T6–L1 intercostal nerves. 2 Petersen P.L. Mathiesen O. Torup H. et al. The transversus abdominis plane block: a valuable option for postoperative analgesia? A topical review. Acta Anaesthesiol Scand. 2010; 54: 529-535 Crossref PubMed Scopus (205) Google Scholar , 3 Rafi A.N. Abdominal field block: a new approach via the lumbar triangle. Anaesthesia. 2001; 56: 1024-1026 Crossref PubMed Scopus (498) Google Scholar , 4 Dierking G.W. Dahl J.B. Kanstrup J. et al. Effect of pre- vs postoperative inguinal field block on postoperative pain after herniorrhaphy. Br J Anaesth. 1992; 68: 344-348 Abstract Full Text PDF PubMed Scopus (185) Google Scholar , 5 Kuppuvelumani P. Jaradi H. Delilkan A. Abdominal nerve blockade for postoperative analgesia after caesarean section. Asia Oceania J Obstet Gynaecol. 1993; 19: 165-169 Crossref PubMed Scopus (30) Google Scholar This provides analgesia to the abdominal wall, a site that has been identified as causing a large portion of post-operative pain in patients undergoing abdominally-based autologous tissue breast reconstruction. 6 Albornoz C.R. et al. The influence of sociodemographic factors and hospital characteristics on the method of breast reconstruction, including microsurgery: a U.S. population-based study. Plast Reconstr Surg. 2012; 129: 1071-1079 Crossref PubMed Scopus (98) Google Scholar , 7 Cordeiro P.G. Breast reconstruction after surgery for breast cancer. N Engl J Med. 2008; 359: 1590-1601 Crossref PubMed Scopus (265) Google Scholar We recently demonstrated in a prospective, randomized, control trial that a liposomal form of bupivacaine, when given as a TAP block in patients undergoing delayed unilateral deep inferior epigastric perforator (DIEP) reconstruction, resulted in decreased post-operative narcotic utilization as compared to a bupivacaine TAP block, pain catheter (OnQ pump) or local infiltration (in press). The goal of this retrospective analysis was to examine the effect that liposomal bupivacaine delivered via a TAP block had on post-operative narcotic utilization compared to a bupivacaine pain catheter in women undergoing bilateral delayed DIEP free flap reconstruction." @default.
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• W2743006806 date "2017-12-01" @default.
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• W2743006806 title "Comparison of local anesthetic infusion pump bupivacaine versus transversus abdominis plane (TAP) block liposomal bupivacaine for pain management after bilateral deep inferior epigastric perforator free flap reconstruction" @default.
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• W2743006806 doi "https://doi.org/10.1016/j.bjps.2017.07.005" @default.
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