Trial reportDrug design, development and therapy2026
Postoperative Analgesia and Recovery with Liposomal Bupivacaine TAP/RSB Block in Elderly Patients Undergoing Laparoscopic Inguinal Hernia Repair: A Randomized Controlled Trial.
Trial report in Drug design, development and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Interpreting the Efficacy of Liposomal Bupivacaine in Fascial Plane Blocks for Elderly Patients: A Methodological Reappraisal [Letter].Drug design, development and therapy · 2026Article
- Methodological Considerations on "Postoperative Analgesia and Recovery with Liposomal Bupivacaine TAP/RSB Block in Elderly Patients Undergoing Laparoscopic Inguinal Hernia Repair: A Randomized Controlled Trial": A Comment on the Study by Gu et al [Letter].Drug design, development and therapy · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Older adults undergoing laparoscopic transabdominal preperitoneal (TAPP) hernia repair often experience inadequate analgesia and delayed mobilization. We tested the hypothesis that dual-plane abdominal wall blocks (transversus abdominis plane + rectus sheath block, TAP+RSB) using liposomal bupivacaine (LB) improve opioid-sparing and recovery versus standard bupivacaine (BP) or no block. Methods: In this single-center, randomized, three-arm trial, 147 patients aged ≥70 years were assigned 1:1:1 to LB‑TAP+RSB (LB group, n=49), BP‑TAP+RSB (BP group, n=49), or no block (control, n=49). Anaesthesia was standardised to maintain BIS 40-60. The primary outcome was 48‑hour opioid consumption (intravenous morphine equivalents). Secondary outcomes included time to first rescue analgesia, pain scores at rest/on movement, time to ambulation, time to extubation, length of stay, and adverse events. Results: Total opioid use was significantly lower in both block groups versus control (BP: -5.53 mg, 95% CI -8.08 to -2.99; LB: -7.24 mg, 95% CI -9.80 to -4.69). Fewer LB patients needed early rescue analgesia than controls (2.0% vs 18.4%, OR 0.10, 95% CI 0.01-0.84). At 8 h, rest pain was lower with LB (P=0.007). Ambulation time was shortest with LB (14.1±2.5 h) compared with BP (16.7±6.5 h) and control (20.0±6.2 h) (both P≤0.006). Extubation occurred earlier in block groups (LB/BP median 2 min vs control 6 min, P<0.001). Hospital stay was shorter with blocks (median 3 vs 4 days, P<0.001). Adverse events did not differ between groups. Conclusion: Dual-plane TAP+RSB, particularly with LB, reduces opioid need and speeds recovery in older TAPP patients, supporting its use in ERAS pathways.
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