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Regional Anesthesia Techniques for Abdominal Operations

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Enhanced Recovery After Surgery

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Abstract

The aim of this chapter is to challenge and encourage anesthesiologists and surgeons to consider adding existing or newer regional anesthesia techniques to their repertoire to minimize postoperative pain following abdominal operations. Use of regional anesthesia techniques is an important and increasingly widely used component of multimodal analgesia. Effective blocks result in reduced use of systemic oral and intravenous analgesics, especially opioids, and allow earlier return to normal function.

The three entwined “Pillars of ERAS” are maintenance of normal function (mobility and gut function), maintenance of fluid and electrolyte balance, and pain management. Pain is a predictable outcome of any procedure that incises, separates, removes, or otherwise disturbs the usual human anatomy. Pain, or even fear and anticipation of pain, can exacerbate and potentiate the physiologic response to injury, including the controlled deliberate injuries of an operation. It is the body’s perception of pain that prompts the release of stress hormones that lead to retention of fluid. Patients avoid movement of the affected part to avoid pain. Hence pain itself causes fluid imbalances and immobility and needs to be controlled to address the basic tenets of enhanced recovery. In addition, when systemic methods of controlling pain include intravenous and oral opioids, gastrointestinal function is further impacted and slows recovery.

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Author information

Authors and Affiliations

  1. Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic College of Medicine, Mayo Clinic, Phoenix, AZ, USA

    Tonia M. Young-Fadok

  2. Department of Anesthesiology and Perioperative Medicine, Division of CV and Thoracic Anesthesia, Mayo Clinic College of Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA

    Ryan C. Craner

Authors
  1. Tonia M. Young-Fadok
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  2. Ryan C. Craner
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Correspondence to Tonia M. Young-Fadok .

Editor information

Editors and Affiliations

  1. Department of Surgery, Örebro University Hospital, Örebro, Sweden

    Olle Ljungqvist

  2. Yeovil District Hospital NHS Foundation Trust Higher Kingston, Yeovil, Somerset, UK

    Nader K. Francis

  3. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s, Hospital Harvard Medical School, Boston, MA, USA

    Richard D. Urman

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Young-Fadok, T.M., Craner, R.C. (2020). Regional Anesthesia Techniques for Abdominal Operations. In: Ljungqvist, O., Francis, N., Urman, R. (eds) Enhanced Recovery After Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-33443-7_16

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  • DOI: https://doi.org/10.1007/978-3-030-33443-7_16

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  • Online ISBN: 978-3-030-33443-7

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