Unilateral TAP Block for Laparoscopic Gastric Sleeve Surgery

Phase 4

Completed

Conditions: Subcostal Transversus Abdominis Plane Block
Laparoscopic Sleeve Gastrectomy

Brief Summary: The study team will be assessing if the unilateral subcostal transversus abdominis plane (TAP) block can decrease pain and improve outcomes following laparoscopic sleeve gastrectomy surgeries.

Detailed Description: This study will be a double-blinded randomized control trial. Patients will be randomized into one of two groups. Patients in Group 1 will undergo general anesthesia with a post-induction, post-intubation, pre-procedural subcostal TAP block with 40 mL 0.25% bupivacaine on the ipsilateral side as the extraction site. Patients in Group 2 will undergo general anesthesia with a post-induction, post-intubation, pre-procedural subcostal TAP block with 40 mL sterile normal saline on the ipsilateral side as the extraction site. Investigators will be blinded to the randomization of these patients. Following performance of these blocks, patients will receive standard care for the surgery as well as during the postoperative recovery period. Data will be obtained from the EPIC electronic medical record, and from the anesthesia computer record. Patients will be asked postoperatively to assess items such as their nausea and pain scores. Patients will also be contacted by phone within 1-2 days of discharge to obtain analgesic satisfaction scores. This data will be collected on the Redcap server.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Prior bariatric surgery of any kind
Previous abdominoplasty
Allergy or intolerance to one of the study medications
ASA > 4
Chronic opioid use (taking opioids for longer than 3 months or daily oral morphine equivalent of >5mg/day for one month)
History of alcohol/drug abuse
History of hepatic or renal insufficiency
Patient refusal

Arm && Interventions

Group	Intervention	Description
Saline	Saline	Patients will undergo general anesthesia with a post-induction, post-intubation, pre-procedural subcostal TAP block with normal saline on the ipsilateral side as the extraction site.
Bupivacaine	Bupivacaine	Patients will undergo general anesthesia with a post-induction, post-intubation, pre-procedural subcostal TAP block with bupivacaine on the ipsilateral side as the extraction site.

Primary Outcome Measures

Name	Time	Method
Amount of 24 Hour Opioid Consumption	24 Hours postoperative	Amount of intravenous (IV) opioid consumption within 24-hour period

Secondary Outcome Measures

Name	Time	Method
Number of Participants Asked Area of Pain on the Body After Surgery	24 Hours postoperative	Patients asked for the areas of pain (right upper quadrant (RUQ), left upper quadrant, (LUQ) right lower quadrant (RLQ), or left lower quadrant (LLQ), diffuse and epigastric) after surgery.
Number of Participants Who Answered Yes to Having Presence of Nausea After Surgery	24 Hours postoperative	Number of participants who answered yes to having presence of nausea after surgery
Amount of Intraoperative IV Opioid Consumption	average 2-3 Hours	Amount of intravenous opioid consumption during the surgery