Initial Experience Using Incisional Anesthetic Catheter In Abdominal Wall Ambulatory Surgery Volume 4 - Issue 1

Castro Diez, Laura¹*, García Jiménez, Maria Lourdes¹, Juncal Díaz, Jorge Luis², López Álvarez Servando², Noguera Aguilar and Jose Francisco¹

• ¹General Surgery Service, Ambulatory Surgery Unit, Spain
• ²Anesthesia Service, Ambulatory Surgery Unit, Spain

Received:January 15, 2021;  Published: January 27, 2021

Corresponding author: Castro Diez Laura, General Surgery Service, Ambulatory Surgery Unit, A Coruña, Spain

DOI: 10.32474/GJAPM.2021.04.000180

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Abstract

Objectives: Abdominal wall pathology, such as inguinal and umbilical hernias, is one of the most prevalent pathologies in the field of General Surgery, with interventions being carried out more and more within outpatient Major Surgery programs. Nevertheless, this pathology is not free from postoperative morbidities or complications, such as postoperative pain, which sometimes requires a longer hospital stay. We present our initial experience using incisional anesthetic catheters in patients who underwent an inguinal or umbilical hernia and analyze various postoperative parameters related to pain and the functional limitation it causes in the patient.

Material and Methods: We intervened a consecutive series of 20 patients with an average age of 60 years with abdominal parietal defects, 15 with a diagnosis of inguinocrural hernia, and 5 with an umbilical or ventral hernia who underwent anterior repair with intraoperative placement of an ON-Q catheter. It is a postoperative analgesia system based on the infusion and release of drugs at the surgical wound level that allows the administration of a variable dose of local anesthetic with a predetermined cadence.

In our case, we made a continuous infusion during the first 60 postoperative hours of 10 ampoules of Levobupivacaine 0.75mg diluted in 200 mL of saline.

Results: We analyzed the results of postoperative pain at discharge, 24 hours and 48 hours with VAS of 0-1 in all patients who were also discharged in less than 8 hours in an Ambulatory Surgery Program and who did not require opioids for controlling the pain. Neither infectious nor mechanical complications of the catheter were recorded, making home management of the system comfortable for patients. Only one patient presented subcutaneous edema in the inguinal incision area which was completely resolved with conservative management.

Discussion: Therefore, it is a simple system that improves the postoperative needs of oral pain relievers, allows the patient to ambulate early and in some cases shortens the hospital stay, resulting in a discharge in Surgery units without admission.

Keywords: Surgery; abdominal wall; pain; catheter; ambulatory surgery

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