Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/10474
Title: Improving postoperative analgesia for transverse rectus abdominis myocutaneous flap breast reconstruction; the use of a local anaesthetic infusion catheter.
Authors: Tan, Kian Jin;Farrow, Hamish
Affiliation: Plastic and Reconstructive Surgery Unit, Austin Hospital, Heidelberg, Victoria, Australia. kjtan_123@yahoo.com.au
Issue Date: 28-Nov-2007
Citation: Journal of Plastic, Reconstructive & Aesthetic Surgery : Jpras 2007; 62(2): 206-10
Abstract: Postoperative pain relief can be delivered either directly to the operative site, or systemically. When effective analgesia can be provided locally, the side effects of systemic analgesia can be avoided, reducing the morbidity of the procedure. We examined the effects of delivering local anaesthetic to the rectus sheath via a multilumen infusion catheter following transverse rectus abdominis myocutaneous (TRAM) flap surgery, and compared the outcomes with patients managed using patient-controlled analgesia (PCA). Forty-six TRAM flap patients received either PCA, local anaesthetic infusion and PCA, or local anaesthetic infusion and supplemental opioid as needed, and the analgesic requirements and morbidity associated with the use of these analgesic medications were recorded. The use of local anaesthetic infusion significantly reduced both total opioid use (71.7% reduction) and nausea, as reflected in the reduction of antiemetic required (51.5% reduction). Fourteen patients were also successful managed with just the infusion catheter and supplementary analgesia, avoiding completely the use of PCA. A 1.5-day reduction in length of hospitalisation was also found. Local anaesthetic infusion delivery to the rectus sheath significantly reduces narcotic requirements, may eliminate the need for PCA, and has an associated significant decrease in the postoperative nausea and vomiting commonly seen in TRAM breast reconstructions.
Internal ID Number: 18054302
URI: http://ahro.austin.org.au/austinjspui/handle/1/10474
DOI: 10.1016/j.bjps.2007.10.034
URL: http://www.ncbi.nlm.nih.gov/pubmed/18054302
Type: Journal Article
Subjects: Amides.administration & dosage
Analgesia, Patient-Controlled
Analgesics, Opioid.administration & dosage
Anesthesia, Local.methods
Anesthetics, Local.administration & dosage
Antiemetics.administration & dosage
Drug Administration Schedule
Female
Humans
Infusion Pumps
Infusions, Intralesional
Mammaplasty.methods
Middle Aged
Morphine.administration & dosage
Pain, Postoperative.prevention & control
Postoperative Nausea and Vomiting.prevention & control
Retrospective Studies
Surgical Flaps
Appears in Collections:Journal articles

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