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Session: ePoster: Quality and Cost 4 (Mon8)

EP652 - Comparing Bupivacaine To Endura-KT Local Anesthetics Transversus Abdominis Plane (TAP) Blocks In Laparoscopic Colorectal Surgery: A Prospective, Randomized, Double-Blind Trial

Monday, May 12, 2025
8:27 AM – 8:32 AM PT
Location: Monitor 7, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Marine Bolliet, MD (she/her/hers)

    General Surgery Resident
    Henry Ford Providence Hospital
    Southfield, MI, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Micheal C. Luca, MD (he/him/his)

    General Surgery Resident
    Ascension Providence Hospital system
    Novi, Michigan, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • BM

    Brooke C. Mower, MD

    Resident Physician
    Ascension Providence Hospital
    Novi, Michigan, United States

    Disclosure information not submitted.

  • PS

    Paul Steffes, M.D.

    Resident
    Ascension Providence
    Ferndale, Michigan, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • AD

    Amir Damadi, MD, FASCRS

    Section Chair Colon and Rectal Surgery
    Providence Hospital Southfield Michigan/Michigan State University
    Southfield, Michigan, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Marine Bolliet, MD: This individual has no financial relationships with ineligible companies.
Micheal C. Luca, MD: This individual has no financial relationships with ineligible companies.
Amir Damadi, MD, FASCRS: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: In laparoscopic colorectal surgery the TAP block has demonstrated decreased postoperative pain, decreased narcotic requirements, and quicker ambulation. Initial studies compared Bupivacaine to placebo, followed by a study comparing liposomal Bupivacaine to Bupivacaine demonstrating improved efficacy with liposomal Bupivacaine. As novel local anesthetics are discovered and combined, they should be compared to the current standards of care to continue to evolve and optimize postoperative care.
The purpose of this study is to compare our current standard local anesthetic Bupivacaine used in TAP blocks for laparoscopic colorectal surgery, to a new local anesthetic, Endura-KT (combination of lidocaine, epinephrine, and tetracaine) to evaluate increased therapeutic benefit in the form of postoperative pain scores, amount of narcotics required for pain control, time to first ambulation, and length of stay, given the longer half life of tetracaine.

Methods/Interventions: This study is a randomized double blind study with 100 patients randomized into the control group of 0.25% Bupivacaine and 100 randomized into the experimental group of Endura-KT. Any patient older than 18 years old undergoing laparoscopic colectomy met inclusion criteria. Exclusion criteria were chronic narcotic use, chronic pain, patients requiring conversion to open surgery, and patients with allergies to the anesthetic. A standardized postoperative pain regimen was used for this study. Patients were asked to fill out their pain scores throughout their postoperative course and to record their first time ambulating. Charts were reviewed to determine the postoperative narcotic requirements and the total length of stay.

Results/Outcomes: Based on the very early preliminary data of four, patients who were randomized to the experimental Endura-KT, marketed as an opioid and preservative free long term solution for post operative pain, were found to have increased postoperative pain scores compared to Bupivacaine on postoperative days 0, 1, and 2 (p=0.0112). Minutes from surgery end time to first ambulation was not statistically significant between both groups (p=0.79). The narcotic requirements postoperatively were not significantly different (p=0.53). Length of stay was also not significantly different (p=0.42).

Conclusion/Discussion: TAP blocks are the standard of care in laparoscopic colon surgery. Liposomal Bupivacaine has been demonstrated to be most effective. This study hopes to demonstrate that Endura-KT (a combination of lidocaine, epinephrine, and tetracaine) may be superior to our current standard of Bupivacaine in the hopes of improving postoperative pain. Our preliminary data suggests that there may not be statistical differences in outcomes, but given limited data due to the recent start of the study, we hope to have more meaningful results upon completion of the study.