Painless abdominoplasty :

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Painless abdominoplasty :. The efficacy of combined intercostal and pararectus blocks in reducing postoperative pain and recovery time. Lu-Jean F eng, M.D. The L u-Jean F eng C linic • Pepper P ike, OH - PowerPoint PPT Presentation

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The efficacy of combined intercostal and pararectus blocks in reducing postoperative pain and recovery time

The efficacy of combined intercostal and pararectus blocks in reducing postoperative pain and recovery timePainless abdominoplasty:Lu-Jean Feng, M.D.The Lu-Jean Feng Clinic Pepper Pike, OHDept. of Plastic Surgery Case Western Reserve University School of Medicine Cleveland, OHNothing to discloseTo evaluate the clinical efficacy of combined intercostal and pararectus blocks for pain control after abdominoplasty by comparing clinical outcomes of patients who had no blocks versus those who had the blocksObjective of studyRecovery room records of 209 patients who underwent abdominoplasties from 2000 to 2009 were reviewedPatients and methodsRecovery room pain scores, pain medications used, and length of time in recovery room were studiedA.B.continued . . . The records of patient questionnaires sent 6 weeks after surgery were also evaluatedPatients and methodsThe questionnaires queried patients pain scores at home, use of narcotics, level of nausea, when they resumed driving and normal activities, and when they were pain-freeC.D.continued . . . Twenty patients met criteria of the control group (no local anesthesia nor nerve blocks)Patients and methodsSeventy-seven patients met criteria of the treatment group (local anesthesia in skin, intercostal block T7 to T12 prior to incision, pararectus block before plication)E.F.Comparision of pain scores in the recovery room for the control group versus the treatment group

Comparision of narcotics given in the recovery room for the control group versus the treatment group

Comparision of length of time in the recovery room for the control group versus the treatment group

Longitudinal pain score comparison between treatment group and control group

Comparison of patients taking narcotics at home following abdominoplasty for the control versus treatment group

The level of nausea experienced at home. The treatment group had significantly less nausea.

Time to pain-free state. The treatment group reached a pain-free state significantly sooner

Time to resume driving. The treatment group began driving significantly sooner.

Time to resume normal activities or return to work. 88% of the treatment group began driving within 2 weeks.

CONCLUSION:Successful long-term relief of pain after abdominoplasty was achieved with a combination of intercostal, ilioinguinal, iliohypogastric and pararectus blocks.Prevention of post-op pain reduces recovery time and allows for faster return to work and normal activities.Unabridged version in November 2010 issue of Plastic and Reconstructive Surgery