Bupivacaine transversus abdominis plane block during complex cesarean delivery for less opioid use afterwards

You may qualify if

• 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 abdominal re-exploration surgery

You can't join if

• Planned general anesthesia
• Supraumbilical skin incision
• History of less than 3 cesarean deliveries if do not meet other inclusion criteria
• 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
• Planned cesarean hysterectomy
• Administration of >4mg morphine to epidural