ArticlePlastic and reconstructive surgery2017
Transversus Abdominis Plane Blocks with Single-Dose Liposomal Bupivacaine in Conjunction with a Nonnarcotic Pain Regimen Help Reduce Length of Stay following Abdominally Based Microsurgical Breast Reconstruction.
Article in Plastic and reconstructive surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07092475 (The Impact of Intraoperative Methadone on Postoperative Opioid Use), which is not on this map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Impact of Intraoperative Methadone on Postoperative Opioid Use
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Effectiveness and safety of liposomal bupivacaine in autologous breast reconstruction: a systematic review.Frontiers in medicine · 2026Pooled it
- Liposomal Bupivacaine in Transversus Abdominis Plane Block for Postoperative Pain Control After Autologous Breast Reconstruction: A Systematic Review and Meta-Analysis.Microsurgery · 2025Pooled it
- Transversus Abdominis Plane Block With Liposomal Bupivacaine vs. Regular Anesthetics for Pain Control After Surgery: A Systematic Review and Meta-Analysis.Frontiers in surgery · 2020Pooled it
- Liposomal bupivacaine after reduction mammaplasty: is it worth the shot? A single-blind, breast-split randomized clinical trial.JPRAS open · 2026Article
- Review
- Regional Anesthesia and Postoperative Opioid Use in Autologous Breast Reconstruction: A Systematic Review and Meta-analysis.Plastic and reconstructive surgery. Global open · 2025Article
- Liposomal bupivacaine and postoperative opioid consumption for oncologic and non-oncologic breast procedures: a literature review and meta-analysis.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2025Review
- ERAS-Based Anesthetic Management of Patients Undergoing Abdominal-Based Free Flap Breast Reconstruction: A Narrative Review.JPRAS open · 2024Review
- The Cost-effectiveness of Enhanced Recovery after Surgery Protocols in Abdominally Based Autologous Breast Reconstruction.Plastic and reconstructive surgery. Global open · 2024Article
- Moving the needle: a narrative review of enhanced recovery protocols in breast reconstruction.Annals of translational medicine · 2023Review
- Survey of Surgeon-reported Postoperative Protocols for Deep Inferior Epigastric Perforator Flap in Breast Reconstruction.Plastic and reconstructive surgery. Global open · 2023Article
- Transversus abdominus plane blocks do not reduce rates of postoperative prolonged opioid use following abdominally based autologous breast reconstruction: a nationwide longitudinal analysis.European journal of plastic surgery · 2023Article
- Evaluating the Efficacy of Two Regional Pain Management Modalities in Autologous Breast Reconstruction.Plastic and reconstructive surgery. Global open · 2022Article
- Factors influencing postoperative abdominal pain in DIEP flap breast reconstruction.Gland surgery · 2021Article
- Practical Review of Abdominal and Breast Regional Analgesia for Plastic Surgeons: Evidence and Techniques.Plastic and reconstructive surgery. Global open · 2020Review
- Perioperative Blocks for Decreasing Postoperative Narcotics in Breast Reconstruction.Anesthesiology and pain medicine · 2020Review
- Basics and Best Practices of Multimodal Pain Management for the Plastic Surgeon.Plastic and reconstructive surgery. Global open · 2020Review
- Reducing the pain: A cost-effectiveness analysis of transversus abdominis plane block using liposomal bupivacaine for outpatient laparoscopic ventral hernia repair.Surgery open science · 2020Article
- Safe anesthesia for office-based plastic surgery: Proceedings from the PRS Korea 2018 meeting in Seoul, Korea.Archives of plastic surgery · 2019Article
- The Expanding Role of Diagnostic Ultrasound in Plastic Surgery.Plastic and reconstructive surgery. Global open · 2018Article
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundSide effects associated with use of postoperative narcotics for pain control can delay recovery after abdominally based microsurgical breast reconstruction. The authors evaluated a nonnarcotic pain control regimen in conjunction with bilateral transversus abdominis plane blocks on facilitating early hospital discharge.
methodsA retrospective analysis was performed of consecutive patients who underwent breast reconstruction using abdominally based free flaps, with or without being included in a nonnarcotic protocol using intraoperative transversus abdominis plane blockade. During this period, the use of locoregional analgesia evolved from none (control), to continuous bupivacaine infusion transversus abdominis plane and catheters, to single-dose transversus abdominis plane blockade with liposomal bupivacaine solution. Demographic factors, length of stay, inpatient opioid consumption, and complications were reported for all three groups.
resultsOne hundred twenty-eight consecutive patients (182 flaps) were identified. Forty patients (62 flaps) were in the infusion-liposomal bupivacaine group, 48 (66 flaps) were in the single-dose blockade-catheter group, and 40 (54 flaps) were in the control group. The infusion-liposomal bupivacaine patients had a significantly shorter hospital stay compared with the single-dose blockade-catheter group (2.65 ± 0.66 versus 3.52 ± 0.92 days; p < 0.0001) and the control group (2.65 ± 0.66 versus 4.05 ± 1.26 days; p < 0.0001). There was no significant difference in flap loss or major complications among groups.
conclusionsWhen used as part of a nonnarcotic postoperative pain regimen, transversus abdominis plane blocks performed with single injections of liposomal bupivacaine help facilitate early hospital discharge after abdominally based microsurgical breast reconstruction. A trend toward consistent discharge by postoperative day 2 was seen. This could result in significant cost savings for health care systems. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.