Direct TAP Blocks with Exparel during Abdominoplasty

Pain control following abdominoplasty is a major source of concern for the patient and surgeon alike. Pain pumps and narcotic medications are currently the frontline therapies. With the following technique, Exparel (liposomal marcaine, 72 hour duration of action) has been used for transversus abdominis plane (TAP) blocks under direct visualization during abdominoplasty. Traditionally, the TAP block has required an anesthesiologist for ultrasound-guided, transcutaneous injection of local anesthetic. Fourteen patients have been treated with the direct, fascial-splitting technique to reach the TAP plane (see figure link below). Primary and secondary endpoints of total narcotic use and patient reported pain scores will be discussed, with a focus on surgical technique.

This represents an exciting opportunity to decrease postoperative pain following abdominoplasty.