Trial Comparing Transversus Abdominis Plane Block Versus Epidural Anesthesia for Pain Management in Colorectal Surgery

Adequate peri-operative analgesia is a vital component of post-operative management for
patients undergoing colon and rectal surgery, affecting hospital length of stay, quality of
life, and patient outcomes. There are many options for the peri-operative management of pain
after elective colorectal surgery.

This is a randomized clinical trial comparing the transversus abdominis plane block using
Exparel® to epidural anesthesia for the enhanced recovery pathway perioperative management of
pain for elective colorectal surgery.

Inclusion Criteria:

- Patients undergoing elective open and minimally invasive (laparoscopic and robotic)
colon and rectal surgery for colorectal neoplasia, diverticulitis, and other diseases
of the colon and rectum;

- Surgical procedure either through standard open or minimal invasive approach
(laparoscopic or robotic);

- Patients > 18 years of age;

- Able to provide informed written consent

- Patients capable of completing questionnaires at the time of consent

Exclusion Criteria:

- Documented allergic reaction to morphine, hydromorphone, lidocaine, bupivicaine and/or
fentanyl;

- Contra-indication to placement of epidural catheter (spinal stenosis, spinal fusion,
elevated INR, anticoagulation, patient refusal, etc) or TAP block (patient refusal);

- Urgent or emergent surgery precluding epidural catheter placement or TAP block;

- Systemic Infection contraindicating epidural catheter placement or TAP block;

- Unwillingness to participate in follow up assessments;

- Prisoners

- Pregnant women