Clinical Proposal for the Comparison of Intraperitoneal Anesthetic to Injected Local Anesthetic
Condition: Pain, Postoperative; Morbid Obesity
MeSH terms: Obesity, Morbid; Pain, Postoperative
Study type: Interventional
Phase: Phase 2

Summary: 
      The purpose of this study is to determine if pre-incisional lidocaine injection, instilled
      liquid bupivacaine, intra-abdominal aerosolized bupivacaine, or post-operative bupivacaine
      injection is superior in post-operative pain control in laparoscopic bariatric surgical
      patients.
    

Detailed description: 
      The research objective is to compare our standard post-operative port site injection of 0.5%
      bupivacaine against pre-incisional port site injection of 1% lidocaine against the
      instillation of streamed bupivacaine 0.5% against the instillation of aerosolized 0.5%
      bupivacaine as it relates to post-operative analgesia usage and pain scale scores. The null
      hypothesis will be that there is no difference between the four arms of the study in regards
      to pain score and analgesia usage.
    

Intervention name(s): Injected bupivacaine post-operatively; Streamed bupivacaine versus streamed normal saline; Aerosolized bupivacaine versus aerosolized saline; Injected lidocaine pre-incision vs saline pre-incision
Intervention type(s): Drug; Drug; Drug; Drug
Intervention description(s): Patients will receive 30 ml of 0.9% normal saline divided equally and injected prior to port site incision, then 10ml of 0.9% normal saline streamed via port directed at operative field, then 10ml of 0.9% normal saline aerosolized into the coelomic cavity prior to deflation, and our current standard of care, which is 30ml of 0.5% bupivacaine, divided equally between the five port-sites, injected at the end of the operation.; Patients will receive 30ml of 0.9% normal saline divided equally and injected prior to port site incisions, then 10ml of 0.5% bupivacaine streamed via port directed at operative field, then 10ml of 0.9% normal saline aerosolized into the coelomic cavity prior to deflation and our current standard of care, which is 30ml of 0.5% bupivacaine, divided equally between the five port-sites, injected at the end of the operation.; Patients will receive 30 ml of 0.9% normal saline divided equally and injected prior to port site incision, then 10ml of 0.9% normal saline streamed via port directed at operative field, then 10ml of 0.5% bupivacaine aerosolized into coelomic cavity prior to deflation and our current standard of care, which is 30ml of 0.5% bupivacaine, divided equally between the five port-sites, injected at the end of the operation.; Patients will receive 30ml of 1% lidocaine divided equally and injected prior to port site incisions, then 10ml of 0.9% normal saline streamed via port directed at operative field, then 10ml of 0.9% normal saline aerosolized into the coelomic cavity prior to deflation and our current standard of care, which is 30ml of 0.5% bupivacaine, divided equally between the five port-sites, injected at the end of the operation.
Other intervention name(s): bupivacaine; bupivacaine; marcaine; normal saline; bupivacaine; marcaine; normal saline; aerosolized; lidocaine; normal saline; pre-emptive
Intervention MeSH terms: Lidocaine; Bupivacaine
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Treatment
Keywords: bupivacaine; marcaine; lidocaine; normal saline; narcotics; analog pain scale; postoperative pain; preemptive; aerosolization; streamed