THE EFFICACY OF COMBINED INTERCOSTAL AND
PARARECTUS BLOCKS IN REDUCING POSTOPERATIVE PAIN AND RECOVERY TIME
PAINLESS 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 disclose
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
OBJECTIVE OF STUDY
Recovery room records of 209 patients who underwent abdominoplasties from 2000 to 2009 were reviewed
PATIENTS AND METHODS
Recovery room pain scores, pain medications used, and length of time in recovery room were studied
A.
B.
continued . . .
The records of patient questionnaires sent 6 weeks after surgery were also evaluated
PATIENTS AND METHODS
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
C.
D.
continued . . .
Twenty patients met criteria of the control group (no local anesthesia nor nerve blocks)
PATIENTS AND METHODS
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)
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
