Impact of Liposomal Bupivacaine on Post-operative Pain, Opioid Use, and Swallow Function in Transoral Robotic Surgery

What this Trial Is About

Researchers are studying patients with oropharyngeal squamous cell carcinoma to understand how to better manage pain after transoral robotic surgery (TORS). The focus is on whether the use of a local anesthetic called EXPAREL4 (Liposomal Bupivacaine) injected into the surgical site can improve pain relief and swallowing function compared to standard postoperative care without this injection. EXPAREL4 is an FDA-approved anesthetic that provides long-lasting pain control when used during surgery. Participants will receive TORS, and some will have liposomal bupivacaine injected into the surgical wound at the end of the procedure. The injection is given at the base of the tongue and/or tonsil, with a total dose of 3-4 mL. Both groups receive standard postoperative pain medications including Tylenol, oxycodone, and morphine as needed. The choice to use liposomal bupivacaine is based on the surgeon's usual practice. The study compares two groups: one with the anesthetic injection plus standard pain medicines and one with standard pain medicines alone. During the study, participants’ pain levels and swallowing ability will be monitored for up to three months after surgery. Assessments include endoscopic swallow studies and surveys on swallowing difficulties. Researchers will also track the amount of pain medication used after surgery. The study aims to measure postoperative pain control and dysphagia outcomes, helping to improve care for patients undergoing TORS for oropharyngeal cancer.

Liposomal Bupivacaine and Transoral Robotic Surgery