Background: Abdominoplasty is a common aesthetic surgery. Adequate pain management during the postoperative period is of great importance. Previous studies have failed to achieve safe and reliable effective analgesic techniques beyond the recovery room. This research aims to investigate the outcome of the abdominoplasty operation for the patients' received transversus abdominis plan block in comparison with the non-blocked patients.Methods: 58 patients, undergoing elective abdominoplasty, received general anesthesia. Patients were randomly assigned to two equal groups of 29 patients each. Combined subcostal and posterior transversus abdominis plane block group and non-blocked group. For both groups, the standard postoperative analgesic regimen consisted of IV Paracetamol 1 g every 6 hours. Values of visual analog scale values were recorded postoperatively, once the patient had a visual analog scale ≥ 4, IV opioids administered and visual analog scale recorded every 30 min till pain improved. The primary outcome was opioids consumption in the first 72 hours postoperatively, the secondary outcome was the value of visual analog scale at rest and movement (or with knee flexion) in the first 72 hours postoperatively, time to first ambulation, time to first incentive spirometer 900 ml/min were recorded and also the incidence of postoperatively mechanical ventilatory support (CPAP) requirements.Results: Morphine consumption in the first 72 hours was 6.97±1.97 in the non-blocked group and 4.38±2.04 in the blocked group (p < 0.05). Pethidine consumption in the first 72 hours was 208.62±85.64 in the non-blocked group and 20.69±25.06 in the blocked group (p < 0.05). VAS was lower in the blocked group during the first 72 hours were (p < 0.05). Time to first ambulation was 12.41±5.04 hours in the non-blocked group and 4.62±1.08 hours in the blocked group (p < 0.05), time to first incentive spirometer 900 ml/min was 11.45±5.05 hours in the non-blocked group and 4.27±1.09 hours in the blocked group (p < 0.05).Conclusion: Combined subcostal and posterior transversus abdominis plane block is a promising regional anesthetic technique for postoperative pain relief in abdominoplasty surgery, it offers a longer postoperative analgesic effect duration and fewer analgesic requirements with less postoperative complications.
Background and aim: Total Abdominal Hysterectomy is a major invasive abdominal surgery which is accompanied with severe postoperative pain. Multimodal analgesia techniques can provide efficient analgesics coverage with minimal side effects, Quadratus Lumborum Block is an abdominal wall block which gives a good analgesic effect for abdominal surgery with lower pain score and less opioids requirements. Case presentation: A 67 years old female was scheduled to undergo total abdominal hysterectomy surgery, she had comorbidities; morbid obesity, bronchial asthma, obstructive sleep apnea, and hypothyroidism. We performed General Anesthesia and by the end of surgery, a Quadratus Lumborum Block was done ultrasound-guided technique. Conclusion: We successfully performed Quadratus Lumborum Block bilaterally which was able to provide a sufficient analgesic effect for Total Abdominal Hysterectomy surgery, giving our patient the opportunity of early ambulation and avoiding opioids side effects especially the respiratory adverse effect.
Background: Abdominoplasty is a common aesthetic surgery. Adequate pain management during the postoperative period is of great importance. This research aims to investigate the outcome of the abdominoplasty operation for the patients who have received transversus abdominis plan block in comparison with the non-blocked patients.Methods: 58 patients, undergoing elective abdominoplasty, patients were randomly assigned to two equal groups of 29 patients each. Combined subcostal and posterior transversus abdominis plane block group and non-blocked group. For both groups, the standard postoperative analgesic regimen consisted of IV Paracetamol 1 g every 6 hours. Values of visual analog scale (VAS) were recorded postoperatively, once the patient had a VAS ≥ 4, IV opioids administered. The primary outcome was opioids consumption in the first 72 hours postoperatively, the secondary outcome was the value of VAS at rest and movement (or with knee flexion) in the first 72 hours postoperatively, time to first ambulation and time to first incentive spirometer 900 ml/min were recorded.Results: Pethidine consumption in the first 72 hours was 208.62±85.64 in the non-blocked group and 20.69±25.06 in the blocked group (p < 0.05). VAS was lower in the blocked group during the first 72 hours either during rest or movement where (p < 0.05). Time to first ambulation was 12.41±5.04 hours in the non-blocked group and 4.62±1.08 hours in the blocked group (p < 0.05), time to first incentive spirometer 900 ml/min was 11.45±5.05 hours in the non-blocked group and 4.27±1.09 hours in the blocked group (p < 0.05).Conclusion: Combined subcostal and posterior transversus abdominis plane block is a promising regional anesthetic technique for postoperative pain relief in abdominoplasty surgery, it offers a longer postoperative analgesic effect duration and fewer analgesic requirements with less postoperative complications.Trial Registration Clinical Trial: TCTR20200602001 “Retrospectively registered” Date of registration on May 30, 2020
Background and aim: Total Abdominal Hysterectomy is a major invasive abdominal surgery which is accompanied with severe postoperative pain. Multimodal analgesia techniques can provide efficient analgesics coverage with minimal side effects, Quadratus Lumborum Block is an abdominal wall block which gives a good analgesic effect for abdominal surgery with lower pain score and less opioids requirements.Case presentation: A 67 years old female was scheduled to undergo total abdominal hysterectomy surgery, she had comorbidities; morbid obesity, bronchial asthma, obstructive sleep apnea, and hypothyroidism. We performed General Anesthesia and by the end of surgery, a Quadratus Lumborum Block was done ultrasound-guided technique.Conclusion: We successfully performed Quadratus Lumborum Block bilaterally which was able to provide a sufficient analgesic effect for Total Abdominal Hysterectomy surgery, giving our patient the opportunity of early ambulation and avoiding opioids side effects especially the respiratory adverse effect.
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