Standard Bupivacaine vs Liposomal Bupivacaine in Colorectal Patients

Pain control is a factor that is central to the surgical patient's postoperative experience.
Opioid pain medications are a mainstay of postoperative pain management. However, these have
several adverse effects.

Multimodal pain regimens to minimize opioid use have become central to enhanced recovery
after surgery (ERAS) protocols. The transversus abdominis plane (TAP) block is one
intervention that contributes to this regimen. Traditionally, TAP blocks are performed with
local anesthetics such as bupivacaine. More recently, these have also been performed with
liposomal bupivacaine, whose duration of action is much greater than regular bupivacaine (96
hours versus 8-9 hours, respectively).

In this study, postoperative opioid usage will be compared between patients receiving regular
bupivacaine and liposomal bupivacaine.

Inclusion Criteria:

- 18 years of age or older

- Undergoing elective colectomy by surgeons of Fairfax Colon and Rectal Surgery

Exclusion Criteria:

- Allergic to local anesthetics

- Unable to provide consent

- Pregnant

- On opioids at home chronically (Patients previously on a regular opioid regimen would
need to be opioid-free for a period of 1 year for inclusion in the study)

- Undergoing emergent operations

- Undergoing loop ileostomy reversal

- Undergoing abdominoperineal resection, pelvic exenteration, or perineal rectal
prolapse repairs