Liposomal Bupivacaine Pharmacokinetics and Breast Milk Excretion After Cesarean Delivery
BACKGROUND: 1 in 300 opioid-naive patients exposed to opioids after cesarean birth are estimated to become persistent users of opioids. The rising prevalence of opioid use in pregnancy has led to a sharp increase in neonatal abstinence syndrome from 1.5 cases per 1,000 hospital births in 1999 to 6.0 per 1,000 hospital births in 2013. Liposomal bupivacaine can provide optimal pain control up to 96 hours following wound infiltration.
GAP: Liposomal bupivacaine pharmacokinetics, milk excretion, and infant safety data are lacking.
HYPOTHESIS: Post cesarean section liposomal bupivacaine wound infiltration can help significantly reduce chronic postpartum pain disorder that historically led to increased rates of chronic opioids use in pregnancy and neonatal abstinence syndrome.
METHODS: Prospective observational study of healthy, low-risk pregnancies, scheduled for elective term cesarean delivery followed by TAP block using liposomal bupivacaine.
IMPACT: The study will provide Anesthesiologists and Obstetricians the evidence they need to counsel women on medication safety in breast-feeding, and in implementing liposomal bupivacaine use in their practice as a reliable, safe alternative to opioids in mnaging postpartum pain.