• Yar L Yeap, Jonathan A Fridell, Derrick Wu, Richard S Mangus, Elizabeth Kroepfl, John Wolfe, and John A Powelson.
• Department of Anesthesia, Indiana University School of Medicine, Indianapolis, Indiana.
• Clin Transplant. 2019 Jun 1; 33 (6): e13581.

BackgroundCurrent practices emphasize a multimodal approach to perioperative analgesia due to higher efficacy and decreased opioid usage. Analgesia for pancreas transplant (PT) has traditionally been managed with intravenous (IV) opioids, and reports of transversus abdominis plane (TAP) blocks are limited in this population.MethodsThree interventions were compared in adult PT patients, including IV opioids, TAP catheter, and TAP block with liposomal bupivacaine. Time to return of intestinal function and oral diet, postoperative pain scores, opioid usage, and length of stay were recorded.ResultsStudy included 197 PT patients: 62 (32%) standard care, 90 (45%) TAP catheters with continuous 0.2% ropivacaine, and 45 (23%) single liposomal bupivacaine TAP block. Pain scores were lowest for the IV opioid group (P < 0.001). The liposomal bupivacaine group had lower pain scores on postoperative days (POD) 1-5 than the TAP catheter group. Opioid use during POD 1-5 was lower for both TAP block groups (P = 0.03). Time to bowel function was faster for the TAP block groups (P < 0.05).ConclusionsCompared with IV opioid analgesia, TAP block interventions were associated with lower overall use of opioids and a faster time to intestinal function following pancreas transplant.© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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