Unilateral TAP Block for Laparoscopic Gastric Sleeve Surgery

This study will be a double-blinded randomized control trial. Patients will be randomized into one of two groups. Patients in Group 1 will undergo general anesthesia with a post-induction, post-intubation, pre-procedural subcostal TAP block with 40 mL 0.25% bupivacaine on the ipsilateral side as the extraction site. Patients in Group 2 will undergo general anesthesia with a post-induction, post-intubation, pre-procedural subcostal TAP block with 40 mL sterile normal saline on the ipsilateral side as the extraction site. Investigators will be blinded to the randomization of these patients. Following performance of these blocks, patients will receive standard care for the surgery as well as during the postoperative recovery period. Data will be obtained from the EPIC electronic medical record, and from the anesthesia computer record. Patients will be asked postoperatively to assess items such as their nausea and pain scores. Patients will also be contacted by phone within 1-2 days of discharge to obtain analgesic satisfaction scores. This data will be collected on the Redcap server.

Inclusion criteria

• Adults 18-80 years old
• Candidate for general anesthesia
• Undergoing laparoscopic sleeve gastrectomy
• Patients of participating surgeons

Exclusion criteria

• Prior bariatric surgery of any kind
• Previous abdominoplasty
• Allergy or intolerance to one of the study medications
• ASA > 4
• Chronic opioid use (taking opioids for longer than 3 months or daily oral morphine equivalent of >5mg/day for one month)
• History of alcohol/drug abuse
• History of hepatic or renal insufficiency
• Patient refusal