eP300 - Outcomes in Colorectal Surgery Comparing Intravenous Lidocaine, Quadratus Lumborum (QL) Block, and Tranversus Abdominis Plane (TAP) Blocks

ePoster Presenter(s)

• 

  Bailey Humphreys, MD

  Resident
  University of TN graduate school of medicine
  University of Tennessee Graduate School of Medicine Knoxville
  Alcoa, TN, United States

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

Author(s)

• AR

  Andrew J. Russ, MD FACS FASCRS, MD

  Associate Professor of Surgery
  University of TN graduate school of medicine
  Knoxville, Tennessee, United States

  Disclosure information not submitted.
• RS

  Ryan Schmocker, MD

  Assistant Professor
  University of TN graduate school of medicine
  Knoxville, Tennessee, United States

  Disclosure information not submitted.
• JB

  Jason Buehler, MD

  Associate Professor
  University of TN graduate school of medicine
  Knoxville, Tennessee, United States

  Disclosure information not submitted.
• GO

  Gulsah Sofia Onar, MPH

  Research Data Coordinator II
  University of Tennessee Graduate School of Medicine
  Knoxville, Tennessee, United States

  Disclosure information not submitted.
• TH

  Trey Henderson, MS

  Research Study Coordinator
  University of TN graduate school of medicine
  Duff, Tennessee, United States

  Disclosure information not submitted.
• JM

  James McLoughlin, MD

  Professor
  University of TN graduate school of medicine
  Knoxville, Tennessee, United States

  Disclosure information not submitted.

Senior Author(s)

• GL

  Gregory Low, MD

  Assistant Professor
  University of TN graduate school of medicine
  Knoxville, Tennessee, United States

  Disclosure information not submitted.

Purpose/Background: Multimodal and regional anesthesia are increasingly utilized as components of enhanced recovery after colorectal surgery protocols in hopes of decreasing postoperative pain, opioid consumption/dependency, and to reduce length of stay. Protocols vary between institutions and no single protocol has been identified as superior to another. In this study, we aimed to compare perioperative outcomes in minimally invasive colorectal surgery among patients that received quadratus lumborum (QL) blocks, transversus abdominis plane (TAP) blocks, and intravenous lidocaine.Methods/Interventions: Data was collected from 194 patients who underwent minimally invasive colorectal surgery. 172 received a QL block, TAP block, or intravenous lidocaine. 22 did not receive a preoperative block or intravenous lidocaine. The main outcomes included length of stay, opioid use in hospital, opioid utilization within 180 days of discharge, and readmission to the hospital. The Statewide and Nationwide Social Vulnerability Index (SVI) was used to compare socioeconomic differences among groups.Results/Outcomes: There was no statistically significant difference in total inpatient morphine milligram equivalent usage, persistent postoperative opioid dependency (PPOD), or readmissions within 180 days. 8.8% of all patients developed PPOD. There was a statistically significant difference in readmissions at 1-30 days (p=0.029) and 61-90 days (p=0.033) between those who received any block and those who received no block preoperatively. The SVI did not strongly predict long term opioid use (p=0.034, r=0.186).Conclusion/

Discussion: Our review found that 8.8% of patients developed persistent postoperative opioid dependency irrespective of type of non-opioid nerve block or identified socioeconomic factors. There were no significant differences among block types. Having any preoperative block was associated with lower readmissions at 1-30 and 61-90 days. SVI was weakly correlated with PPOD. Additional research is needed to further minimize long term postoperative opioid use and optimize perioperative analgesia in colorectal surgery.Descriptive statistics for the total opioid use (MME) and length of hospital stay and differences between the nerve block and non-nerve block groups using Kruskal Wallis test Table 8. Showing no significant difference in opioid utilization among perioperative analgesia type.