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Ultrasound-Guided Subcostal Transversus Abdominis Plane Infiltration With Liposomal Bupivacaine for Patients Undergoing Robotic-Assisted Hysterectomy: A Retrospective Study
  1. Jacob Hutchins, MD*,
  2. Rachel Isaksson Vogel,
  3. Rahel Ghebre, MD,
  4. Amy McNally, MD,
  5. Levi S. Downs, MD,
  6. Elizabeth Gryzmala* and
  7. Melissa A. Geller, MD
  1. *Department of Anesthesiology,
  2. Masonic Cancer Center Biostatistics and Bioinformatics, and
  3. Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN.
  1. Address correspondence and reprint requests to Melissa A. Geller, MD, Mayo Mail Code 395, 420 Delaware St SE, Minneapolis, MN 55455. E-mail:


Objective We sought to determine the effect of a subcostal transversus abdominis plane (TAP) block with liposomal bupivacaine on postoperative maximal pain score and length of hospital stay among women undergoing robotic-assisted hysterectomy.

Methods This was a retrospective study comparing patients before and after consistent implementation of TAP blocks with liposomal bupivacaine during robotic-assisted hysterectomies at a single academic institution. Analysis compared patient demographic and operative characteristics by TAP block use, along with outcomes of interest, including postoperative pain and length of hospital stay.

Results There was a statistically significant decrease in maximal numerical rating scale pain scores, presence of nausea and vomiting, and length of hospital stay in those who had a TAP block with liposomal bupivacaine compared with those who did not receive a TAP block. These differences remained even after adjustment for potential confounders.

Conclusions In this retrospective study, liposomal bupivacaine used in a TAP block was a useful method to provide postoperative pain control in patients undergoing robotic-assisted hysterectomy and was associated with lower postoperative maximal pain scores and length of hospital stay.

  • Robotic hysterectomy
  • Anesthesia
  • TAP block
  • Postoperative pain

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  • Research reported in this publication was supported in part by the National Institutes of Health (Grant No. P30 CA77598) using the Biostatistics and Bioinformatics Core–shared Resource of the Masonic Cancer Center, University of Minnesota, and by the National Center for Advancing Translational Sciences of the National Institutes of Health (Award No. UL1TR000114).

  • Jacob Hutchins is on the speaker’s bureau and is a consultant for Pacira Pharmaceuticals. The remaining authors declare no conflicts of interest.