Surgical Site Infiltration for Abdominal Surgery: A Novel Neuroanatomical-based Approach.

Area of Science:

• Anesthesiology
• Surgical Oncology
• Pain Management

Background:

• Effective postoperative analgesia is crucial for patient ambulation and rehabilitation.
• Multimodal analgesia strategies often incorporate nonopioid analgesics and regional techniques.
• Surgical site local anesthetic infiltration is a key component of regional analgesia.

Purpose of the Study:

• To present a novel, neuroanatomy-guided approach to surgical site infiltration for abdominal surgery.
• To optimize postoperative pain management through precise local anesthetic administration.

Main Methods:

• Conducted literature searches for studies on abdominal surgery pain sources.
• Reviewed identified studies and manually retrieved relevant publications.
• Synthesized neuroanatomical findings to inform infiltration technique.

Main Results:

• An optimal technique involves systematic, extensive infiltration in peritoneal, subfascial, and subdermal planes.
• Recommended volume: 1-1.5 mL per 1-2 cm of incision per layer.
• Utilized a 22-gauge, 1.5-inch needle with slow withdrawal during injection to minimize intravascular risk.

Conclusions:

• Meticulous, extensive surgical site infiltration effectively manages postoperative pain.
• This technique, combined with other nonopioids, should be prioritized over opioids for rescue.
• Further research is needed to validate the analgesic efficacy of this proposed infiltration method.