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Pain Medicine 2014; 15: 1312–1315 Wiley Periodicals, Inc.
Case Report Infiltration of Liposome Bupivacaine into the Transversus Abdominis Plane for Postsurgical Pain Management in a 39-Year-Old Female Undergoing Laparoscopic Cholecystectomy
Dragan Gastevski, MD Department of Anesthesiology and Pain Medicine, Advocate South Suburban Hospital, Hazel Crest, Illinois, USA Reprint requests to: Dragan Gastevski, MD, Department of Anesthesiology and Pain Medicine, Advocate South Suburban Hospital, 17800 Kedzie Avenue, Hazel Crest, IL 60429 USA. Tel: 708-213-3328; Fax: 708-213-0161; E-mail: [email protected]. Editorial assistance was provided by Bina Patel, PharmD, of Peloton Advantage, LLC, and supported by Pacira Pharmaceuticals, Inc. The author is fully responsible for the content, editorial decisions, and opinions expressed in the current article. The author did not receive an honorarium related to the development of this manuscript. The author has served as a paid speaker for Pacira Pharmaceuticals, Inc.
Abstract Introduction. Pain after laparoscopic cholecystectomy is reportedly complex and multifaceted, and has been cited as the most frequent reason for prolonged convalescence. The use of opioid therapy, a common pain management strategy, can be limited by potentially severe adverse events. In this report, I describe the use of liposome bupivacaine, administered via transversus abdominis plane (TAP) infiltration, in a patient undergoing emergency laparoscopic cholecystectomy. Case. The patient underwent an emergency laparoscopic cholecystectomy complicated by an unexpected correction of partially detached mesh implanted during prior ventral hernia repair. The patient was discharged to the post-anesthesia care unit, but reported a pain score of 8 (11-point scale; 1312
10 = worst possible pain). Fentanyl rescue therapy failed to alleviate the pain. Liposome bupivacaine was administered via bilateral TAP infiltration as postsurgical rescue pain medication, part of a multimodal analgesic regimen. Results. The patient tolerated the TAP infiltration well and subsequently reported a pain score of 2 and a pain satisfaction score of 10 (11-point scale; 10 = completely satisfied). No additional analgesics were required. The patient was discharged on postoperative day 1, resumed normal activities in
Pain Medicine 2014; 15: 1312–1315 Wiley Periodicals, Inc.
Case Report Infiltration of Liposome Bupivacaine into the Transversus Abdominis Plane for Postsurgical Pain Management in a 39-Year-Old Female Undergoing Laparoscopic Cholecystectomy
Dragan Gastevski, MD Department of Anesthesiology and Pain Medicine, Advocate South Suburban Hospital, Hazel Crest, Illinois, USA Reprint requests to: Dragan Gastevski, MD, Department of Anesthesiology and Pain Medicine, Advocate South Suburban Hospital, 17800 Kedzie Avenue, Hazel Crest, IL 60429 USA. Tel: 708-213-3328; Fax: 708-213-0161; E-mail: [email protected]. Editorial assistance was provided by Bina Patel, PharmD, of Peloton Advantage, LLC, and supported by Pacira Pharmaceuticals, Inc. The author is fully responsible for the content, editorial decisions, and opinions expressed in the current article. The author did not receive an honorarium related to the development of this manuscript. The author has served as a paid speaker for Pacira Pharmaceuticals, Inc.
Abstract Introduction. Pain after laparoscopic cholecystectomy is reportedly complex and multifaceted, and has been cited as the most frequent reason for prolonged convalescence. The use of opioid therapy, a common pain management strategy, can be limited by potentially severe adverse events. In this report, I describe the use of liposome bupivacaine, administered via transversus abdominis plane (TAP) infiltration, in a patient undergoing emergency laparoscopic cholecystectomy. Case. The patient underwent an emergency laparoscopic cholecystectomy complicated by an unexpected correction of partially detached mesh implanted during prior ventral hernia repair. The patient was discharged to the post-anesthesia care unit, but reported a pain score of 8 (11-point scale; 1312
10 = worst possible pain). Fentanyl rescue therapy failed to alleviate the pain. Liposome bupivacaine was administered via bilateral TAP infiltration as postsurgical rescue pain medication, part of a multimodal analgesic regimen. Results. The patient tolerated the TAP infiltration well and subsequently reported a pain score of 2 and a pain satisfaction score of 10 (11-point scale; 10 = completely satisfied). No additional analgesics were required. The patient was discharged on postoperative day 1, resumed normal activities in
