TAP Blocks With Ropivacaine Continuous Infusion Catheters vs Single Dose Liposomal Bupivicaine After Kidney Transplant

This study is a comparison of the analgesic efficacy of TAP blocks provided by ropivacaine
bolus plus continuous ropivacaine infusion via catheters versus single shot TAP blocks with
liposomal bupivacaine.

In the Liposomal Bupivacaine group, TAP block will be performed using ultrasound guidance.
12ml of 0,25% plain bupivacaine will be used for skin infiltration and to open up the TAP.
Liposomal Bupivacaine 266 mg (1.3% in 20 ml) will be diluted to 40 ml volume with 20 ml of
preservative free normal saline. 20 ml (133mg) of liposomal bupivicaine will then be injected
into the TAP.

For those randomized to the TAP catheter group, ultrasound guidance will be used for TAP
block and 5 mls 1% lidocaine will be used for skin infiltration. A peripheral nerve catheter
will be placed approximately 3-5 cm into the TAP space after injection of ropivacaine. A
bolus dose of 2.5 mg/kg of ropivacaine will be administered in a volume of 30 ml up to a
maximum of 150 mg. An infusion with a programmable pump will be initiated at a rate of 8
ml/hr of 0.2% ropivacaine on the inpatient floor.

Inclusion Criteria:

- Patients ages 18 years or older

- Renal Transplant Recipients

Exclusion Criteria:

- Patients less than 18 years of age

- Pregnant Women

- Prisoners

- Opioid Tolerant Patients taking more than 30 mg/day of oral morphine equivalent
analgesia

- Patients on Systemic anti coagulation

- Patients unable to provide consent

- Hypersensitivity to amide-type local anesthetic or any component of the drug formula