Continuous local analgesia is effective in postoperative pain treatment after medium and large incisional hernia repair

Gherghinescu, Mircea; Copotoiu, Constantin; Lazăr, Alexandra; Popa, D; Mogoantă, Stelian Ştefăniţă; Molnar, Călin

doi:10.1007/s10029-017-1625-8

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…As regards the first macro-area (laparotomy), all the analyzed studies agree in demonstrating the superiority of CWI compared to single-shot nerve blocks or placebo in ensuring better pain relief, lower opioid consumption, lower opioid-related side effects; enhancing, at the same time, the postoperative recovery. [21][22][23][24][25][26][27] Unfortunately, the same conclusions cannot be drawn when CWI is compared to epidural analgesia (EA). In this field there is a high heterogeneity and, while some RCTs have shown a better or similar analgesic effect of CWI when compared to EA, [28][29][30][31][32][33][34][35] others have claimed exactly the opposite; [36][37][38] often in the face of a higher incidence of side effects (ie, treatment failure, vasopressor requirement, prolonged recovery time) and higher costs.…”

Section: Lower Limb Surgerymentioning

confidence: 99%

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

Paladini

Carlo

Musella

et al. 2020

JPR

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Local infiltration and continuous infusion of surgical wound with anesthetics are parts of multimodal analgesia for postoperative pain control. The techniques, given the simplicity of execution that does not increase the timing of the intervention and does not require additional technical skills, are applied in several kinds of surgeries. The continuous wound infiltration can be used for days and a variety of continuous delivery methods can be chosen, including patientcontrolled analgesia, continuous infusion or intermittent bolus. The purpose of this narrative review is to analyze the literature, in particular by researching the safety, efficacy and current perspectives of continuous wound infiltration for postoperative pain management in different surgical settings. We have identified 203 articles and 95 of these have been taken into consideration: 17 for the lower limb surgery; 7 for the upper limb surgery, 51 for the laparotomy/ laparoscopic surgery of the abdominopelvic area, 13 studies regarding breast surgery and 7 for cardiothoracic surgery. The analysis of these studies reveals that the technique has a variable effectiveness based on the type of structure involved: it is better in structures rich in subcutaneous and connective tissue, while the effectiveness is limited in anatomic districts with a greater variability of innervation. However, regardless the heterogeneity of results, a general reduction in pain intensity and in opioid consumption has been observed with continuous wound infiltration: it is an excellent analgesic technique that can be included in the multimodal treatment of postoperative pain or represents a valid alternative when other options are contraindicated.

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Section: Lower Limb Surgerymentioning

confidence: 99%

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

Paladini

Carlo

Musella

et al. 2020

JPR

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“…But this decrease in opioid consumption is limited to the first 24 hours postoperatively, as ropivacaine and bupivacaine are both long-acting local anesthetics, but no longer than 15 to 20 hours [33]. Besides reducing the opioid after surgery, good management of postoperative pain decreases the risks of incisional hernias [34].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of transversus abdominis plane block in pain control after general abdominal surgery – a short review of the literature

Butiulca

Lazăr

2021

Acta Marisiensis - Seria Medica

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Objective: The aim of the study is the assessment of the analgesic efficacy of transversus abdominis plane block in patients undergoing general abdominal surgery. Methods: Pubmed, Scopus, and Medline databases were searched for papers evaluating the effect of transversus abdominis plane block. The primary and secondary outcomes of the studies were analyzed. Results: A total of 10 studies were analyzed, including 717 patients. Studies revealed that transversus abdominis plane block was associated with significantly reduced postoperative discomfort and reduced opioid consumption. Conclusion: The present study shows the clear benefit brought by the transversus abdominis plane block as part of multimodal analgesia, with a significant reduction of pain and higher comfort scores.

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“…Multimodal postoperative analgesia appears to provide better outcomes [31]. Usually, the combination of acetaminophen with a non-steroidal anti-inflammatory drug is sufficient for most patients, but in some cases, local analgesia [32], or even patient-controlled epidural analgesia may be needed. In case of prolonged use of non-steroidal antiinflammatory drugs (NSAID), prophylaxis of gastroduodenal disorders like erosions, hemorrhage or ulcers should be considered, especially if the patient's oral feeding has been temporarily suspended.…”

Section: Digestive System Surveillancementioning

confidence: 99%

Postoperative Follow-Up and Recovery after Abdominal Surgery

Mogoantă¹,

Paitici²,

Mogoanta³

2021

Abdominal Surgery - A Brief Overview

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Postoperative patient care has several components: - surveillance, − prevention of complications associated with surgical disease or other preexisting comorbidities, − specific postoperative treatment of the surgical disease and its complications. While these distinctions are purely didactic, the postoperative care merges into an active surveillance with a higher level of standardization than it would seem at first glance. Computing, interpreting and integrating signs and symptoms with active search of proofs by lab tests or other paraclinical explorations highly depends on skills and dedication of the entire healthcare team. Those attributes gained through continuous theoretical preparation but validated by current practice bring added value, always in favor of the patients’ best interests. In this chapter, we propose to explore the main clinical and paraclinical means and tools that can improve the outcomes of surgical procedures for a faster and safer recovery. We will also discuss the need for different types of surgical bed drains placement and their management, the use of antibiotics and thrombotic event prophylaxis.

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Continuous local analgesia is effective in postoperative pain treatment after medium and large incisional hernia repair

Abstract: Continuous local analgesia reduces the need for systemic opioids and can be successfully used in the postoperative pain management after medium and large incisional hernias treated by open surgery.

Cited by 7 publications

References 19 publications

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

Efficacy of transversus abdominis plane block in pain control after general abdominal surgery – a short review of the literature

Postoperative Follow-Up and Recovery after Abdominal Surgery

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