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Varna Medical Forum

Regional anesthetic techniques for postoperative pain management in abdominal surgery: A review

Ozan-Iv Bayrak, Dimitar Chavdarov

Abstract

Introduction: Pain after surgical intervention continues to be a major challenge for medicine worldwide. Surgical pain is a specific type of acute pain in the modern age of medicine. It arises with the development of new surgical techniques and has one unique characteristic—it is predictable and preventable. Despite better understanding of the physiology, pharmacology, and mechanisms of pain, more than 50% of hospitalized patients report experiencing pain after procedures.

In recent years, there has been increasing interest in regional anesthesia techniques and their inclusion in a multimodal analgesia approach. Especially following the introduction of ultrasound navigation, infiltrative techniques as part of regional anesthesia are gaining attention. Some of the most commonly used blocks include local infiltration analgesia (LIA), transversus abdominis plane block (TAP block), quadratus lumborum block (QLB), and erector spinae plane block (ESP).

Aim: To study the existing regional analgesia techniques in abdominal surgeries by analyzing the available literature in PubMed, Google Scholar, Cochrane Library, and Medscape.

Objectives: To evaluate the existing regional analgesia techniques and their extent and method of application in abdominal surgeries.

Conclusions: Fascial blocks, especially after the introduction of ultrasound techniques, have revolutionized the concept of intra- and postoperative analgesia in abdominal surgeries. They are becoming an excellent alternative to epidural analgesia, as they are easier to perform and carry significantly lower risks and complications compared to neuraxial anesthesia. Their inclusion is highly recommended as part of multimodal analgesia and enhanced recovery after surgery (ERAS) protocols.


Keywords

regional anesthesia, infiltrative blocks, postoperative analgesia

Full Text


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DOI: http://dx.doi.org/10.14748/vmf.v14i1.10099

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