Analgesia for postoperative myomectomy pain: A comparison of ultrasound-guided transversus abdominis plane block and wound infiltration

Osaheni, O; Idehen, H O; Imarengiaye, CO

doi:10.4103/njcp.njcp_162_19

Cited by 2 publications

(3 citation statements)

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“…Compared to TAP, single WI showed inferior analgesia [226][227][228]. However, CWI as part of multimodal management showed better [229] or similar analgesic effect as PCA-IV fentanyl [225], and this finding might be important in cancer surgery patients [229].…”

Section: Gynecological Surgerymentioning

confidence: 92%

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Stamenković

Bezmarević

Bojić

et al. 2021

JCM

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Local anesthetic wound infiltration (WI) provides anesthesia for minor surgical procedures and improves postoperative analgesia as part of multimodal analgesia after general or regional anesthesia. Although pre-incisional block is preferable, in practice WI is usually done at the end of surgery. WI performed as a continuous modality reduces analgesics, prolongs the duration of analgesia, and enhances the patient’s mobilization in some cases. WI benefits are documented in open abdominal surgeries (Caesarean section, colorectal surgery, abdominal hysterectomy, herniorrhaphy), laparoscopic cholecystectomy, oncological breast surgeries, laminectomy, hallux valgus surgery, and radical prostatectomy. Surgical site infiltration requires knowledge of anatomy and the pain origin for a procedure, systematic extensive infiltration of local anesthetic in various tissue planes under direct visualization before wound closure or subcutaneously along the incision. Because the incidence of local anesthetic systemic toxicity is 11% after subcutaneous WI, appropriate local anesthetic dosing is crucial. The risk of wound infection is related to the infection incidence after each particular surgery. For WI to fully meet patient and physician expectations, mastery of the technique, patient education, appropriate local anesthetic dosing and management of the surgical wound with “aseptic, non-touch” technique are needed.

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Section: Gynecological Surgerymentioning

confidence: 92%

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Stamenković

Bezmarević

Bojić

et al. 2021

JCM

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“…In fact, the reason for the addition of lidocaine to this solution was that the local vasodilator effects of this local anesthetic could partially counterbalance the prominent vasoconstriction of adrenaline. Moreover, studies have clearly confirmed that local anesthetic infiltration at the site of surgery could eliminate the postoperation pain and the need for analgesics 20,21 . Several other studies have shown the promising effects of local anesthetic infiltration to reduce intra‐operative bleeding, however, the underlying mechanism is not yet well understood 22 .…”

Section: Discussionmentioning

confidence: 97%

“…Moreover, studies have clearly confirmed that local anesthetic infiltration at the site of surgery could eliminate the postoperation pain and the need for analgesics. 20,21 Several other studies have shown the promising effects of local anesthetic infiltration to reduce intra-operative bleeding, however, the underlying mechanism is not yet well understood. 22 Of course, it should be noted that none of our cases were affected by this complication.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial

Mansour‐Ghanaei

Hosseinzadeh

Sharami

et al. 2022

Health Science Reports

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Background Uterine fibroid is a common benign pelvic tumor and abdominal myomectomy may cause excessive intraoperative bleeding, which may lead to adverse outcomes. Objective This study was planned to evaluate the effectiveness of the injection of lidocaine plus epinephrine to reduce intraoperative bleeding in abdominal myomectomy. Methods During October 2019 and May 2020, 60 eligible women with uterine fibroids were enrolled in a randomized controlled trial. Our patients were divided into two groups of lidocaine plus epinephrine defined as Group L and placebo defined as Group P. In group L, lidocaine 3 mg/kg plus 0.5 ml of adrenaline which reached to 50 cc with saline solution and in group P, 50 ml of normal saline was used. Both the combined solution and normal saline were infiltrated to the serous and myometrium above and around the fibroid before incision. Patients' demographic data, total operative time, hemoglobin changes, and the degree of surgical difficulty were evaluated and compared between the two groups. Results There was no significant difference between the two groups in terms of demographic data. Hemoglobin changes ( p 0.0001) and the degree of surgery difficulty ( p = 0.01) were significantly lower in Group L compared with Group P. In each group the drop in hemoglobin levels from baseline to 4 h postoperatively was significant ( p 0.0001). A significantly meaningful correlation was reported between hemoglobin changes and the degree of surgery difficulty with the size of the uterine and fibroids ( p < 0.05). While a negative correlation was found regarding gravidity and surgery difficulty ( r = −0.413, p = 0.02). Surgery duration was longer in Group P compared with Group L 70.66 ± 19.85 versus 66.16 ± 14.48, respectively, but with no significant difference ( p = 0.32). No significant adverse reaction or serious complication was reported in the two groups. Hemodynamic parameters were kept in the normal range throughout the surgery. Conclusion A combination of lidocaine plus epinephrine during abdominal myomectomy appears to be a safe and effective method in reducing blood loss.

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Analgesia for postoperative myomectomy pain: A comparison of ultrasound-guided transversus abdominis plane block and wound infiltration

Cited by 2 publications

References 0 publications

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Safety and efficacy of lidocaine plus epinephrine on intraoperative bleeding in abdominal myomectomy: A double‐blind clinical trial

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