Symptoms and General Pathology

All Conditions

Digestive System Diseases

Nervous System Diseases

Pain, Postoperative

Pain

Diverticulitis

Gastrointestinal Diseases

Postoperative Complications

Neurologic Manifestations

Diverticulum

Diverticular Diseases

Gastroenteritis

Central Nervous System Depressants

All Drugs and Chemicals

Analgesics

Vasoconstrictor Agents

Respiratory System Agents

Herbal and Botanical

Anesthetics

Bupivacaine

Epinephrine

Anesthetics, Local

Racepinephrine

Epinephryl borate

Narcotics

Cola

30 milliliters (ml) of 0.5% marcaine with epinephrine

exparel 20ml, diluted with 10ml sterile saline for total of 30ml

30ml of bupivacaine were injecting into the subcutaneous tissue at the incision sites after surgery in the OR

30ml of Bupivacaine liposome injectable suspension were injecting into the subcutaneous tissue at the incision sites after surgery in the OR

Bupivacaine liposome suspension

Rachel Knudson, DO

The purpose of the study is to evaluate the effect of Exparel on pain control and patient outcome after colon resection. The investigators will evaluate the clinical course of the patients who receive exparel as compared to the patients who do not receive exparel. Exparel is a 72 hour bupivacaine which is slowly released from lysosomes over the course of three days. A long acting local anesthetic should provide better pain control than conventional bupivacaine which has a 3.5 hour half-life.

Patients who are undergoing elective colon resection with Dr. Kraemer and Dr. Raman will be offered participation in the study. This will include robotic, laparoscopic and open procedures.

In the pre-operative area prior to surgery, the surgical resident will inform the patient of the opportunity to participate in the research study. The resident will consent the patient at that time, if the patient chooses to participate, they will be randomized to an exparel or non-exparel group. The randomization will be done by having the resident pick an envelope that will state whether or not the patient is randomized to the exparel or non-exparel group, this will randomize to 50% in each group. The patient will not be notified of the type of local anesthetic they receive. The attending surgeon will also be blind to the type of local the pt will receive; only the resident and Operating Room (OR) staff will know what type of local anesthetic was given. Unfortunately the opaque color of the exparel precludes the physician injecting the local anesthetic from being blinded to the type of anesthetic given.

The patient will be taken to the operating room as usual, and the surgery will proceed as it normally would. At the end of the surgery the patient will receive either exparel or bupivacaine depending upon which the patient was randomized to. The attending surgeon will not be in the operating suite while the local anesthetic is being injected. 30 milliliters (mL) of either exparel or bupivacaine will be injected into the subcutaneous tissues at the end of surgery.

The patient will be taken to the post operative care unit (PACU), the medications for post-operative pain will be standardized between the two groups, a standard starting dose on the patient controlled analgesia (PCA) will be used, and will be adjusted as needed. The postoperative care will attempt to be standardized in regard to diet, discharge (dc) of foley, not using nasogastric (NG) tubes, however this will be based on the individual patient was what is best for their care. This data will then be analyzed to determine if exparel has a beneficial effect on surgical care.

The Effect of Exparel on Post Operative Pain and Narcotic Use After Colon Surgery

We recorded if an NG was placed immediately post operatively

Will measure the amount of PCA use for the first 48 hours after surgery.

the amount of post operative oral narcotic is measured post op

the total amount of IV narcotic is measured that is given during post op period prior to discharge

The investigators will talk to the patient after surgery immediately post operatively Post Operative Day (POD) #3-5 and POD #13-15 and ask the patients to rate their pain on a scale of 1-10.

The investigators will ask the patient to rate their satisfaction with pain control.

The investigators will ask the patients how many of their narcotic pain pills they used after surgery up to the POD #13-15

Mercy Medical Center

Des Moines University

The study personnel have left the institution or are unreachable. efforts were made to contact the PI/study team members but were unsuccessful. Efforts were also made to get data from Mercy IRB and patient records staff. These staff did not have the information to find such data. Available data from the publication has been entered, but no other data is available and all efforts to locate the data have been exhausted.

30 milliliters (ml) of 0.5% marcaine with epinephrine

Bupivacaine: 30ml of bupivacaine were injecting into the subcutaneous tissue at the incision sites after surgery in the OR

exparel 20ml, diluted with 10ml sterile saline for total of 30ml

Bupivacaine liposome suspension: 30ml of Bupivacaine liposome injectable suspension were injecting into the subcutaneous tissue at the incision sites after surgery in the OR

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
The Effect of Exparel on Post Operative Pain and Narcotic Use After Colon Surgery	NCT02052557	Post-operative ... Colon Cancer Diverticulitis	Bupivacaine Bupivacaine lip...	18 Years -	Des Moines University
The Effect of Exparel on Post Operative Pain and Narcotic Use After Colon Surgery	NCT02052557	Post-operative ... Colon Cancer Diverticulitis	Bupivacaine Bupivacaine lip...	18 Years -	Des Moines University

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