COMFORT Trial: Complex Obstetric Management With Focused Regional Transversus Abdominis Plane Block

Inclusion Criteria15

• Patient has a history of a least one of the following:
• Prior exploratory laparotomy
• History of non-obstetric open intra-abdominal surgery
• History of three or more prior cesarean deliveries
• History of intra-abdominal or pelvic adhesive disease
• History of abdominoplasty
• History of abdominal re-exploration surgery
• History of chronic opioid use
• History of substance abuse (i.e. alcohol, methamphetamine/amphetamine, abuse of prescription opioid medication, or heroin use)
• History of chronic kidney disease
• Allergies to bupivacaine or oral analgesics
• Patient preference
• Cesarean hysterectomy
• Administration of ≥4mg morphine to epidural
• Loss to follow-up