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PAINLESS ABDOMINOPLASTY:
THE EFFICACY OF COMBINED
INTERCOSTAL AND PARARECTUS
BLOCKS IN REDUCING
POSTOPERATIVE PAIN AND
RECOVERY TIME
Lu-Jean Feng, M.D.
The Lu-Jean Feng Clinic • Pepper Pike, OH
Dept. of Plastic Surgery • Case Western Reserve
University School of Medicine • Cleveland, OH
Nothing to disclose
OBJECTIVE OF STUDY
To 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 blocks
PATIENTS AND METHODS
A. Recovery room records of 209 patients
who underwent abdominoplasties from
2000 to 2009 were reviewed
B. Recovery room pain scores, pain
medications used, and length of time
in recovery room were studied
continued . . .
PATIENTS AND METHODS
C. The records of patient questionnaires
sent 6 weeks after surgery were also
evaluated
D. The questionnaires queried patient’s
pain scores at home, use of narcotics,
level of nausea, when they resumed
driving and normal activities, and when
they were pain-free
continued . . .
PATIENTS AND METHODS
E. Twenty patients met criteria of the
control group (no local anesthesia nor
nerve blocks)
F. Seventy-seven patients met criteria of
the treatment group (local anesthesia
in skin, intercostal block T7 to T12 prior
to incision, pararectus block before
plication)
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