Post-operative analgesia is both necessary for patient comfort and satisfaction. Peripheral nerve block offer both good post-operative analgesia and patient satisfaction, but rarely cover the entire period of post-ope...Post-operative analgesia is both necessary for patient comfort and satisfaction. Peripheral nerve block offer both good post-operative analgesia and patient satisfaction, but rarely cover the entire period of post-operative pain. Nonnarcotic drugs are extremely helpful, but with severe pain, narcotics are usually used to help with post-operative pain when the nerve block wears off. However, nausea and vomiting, as well as other side effects associated with narcotic use can be severe and limit their use for post-operative analgesia. The addition of supplements to the local anesthetic used for the nerve blocks can extend the analgesia, but few blocks last greater than 24 hours. We describe the use of a relatively new extended release bupivacaine, Exparel that provide significantly longer analgesia than presently used single shot techniques protocols for extended nerve block analgesia.展开更多
Background: Obesity, particularly in the setting of comorbid disease, presents a unique challenge. Clinicians are pursuing areas of multimodal analgesia in an effort to minimize narcotic dosages. Post-operatively, the...Background: Obesity, particularly in the setting of comorbid disease, presents a unique challenge. Clinicians are pursuing areas of multimodal analgesia in an effort to minimize narcotic dosages. Post-operatively, their pain management can be even more challenging, which includes appropriate use of narcotics in a patient that has a high probably of sleep apnea. Aim: To show that the use of liposomal bupivacaine (Exparel) can provide effective post-operative pain relief and decrease the use of post-operative narcotics. Case: We report on a 62 years old female with a history of hypertension, obesity and a greater than a 40 pack year history of smoking who presented for a modified radical mastectomy with a lymph node dissection. At the end of the case, the patient’s wound was infiltrated with both free bupivacaine and Exparel that minimized her need for post-operative narcotics. Conclusion: We believe that the use of extended release local anesthetics should be considered when there is a need to reduce the use of post-operative narcotics.展开更多
文摘Post-operative analgesia is both necessary for patient comfort and satisfaction. Peripheral nerve block offer both good post-operative analgesia and patient satisfaction, but rarely cover the entire period of post-operative pain. Nonnarcotic drugs are extremely helpful, but with severe pain, narcotics are usually used to help with post-operative pain when the nerve block wears off. However, nausea and vomiting, as well as other side effects associated with narcotic use can be severe and limit their use for post-operative analgesia. The addition of supplements to the local anesthetic used for the nerve blocks can extend the analgesia, but few blocks last greater than 24 hours. We describe the use of a relatively new extended release bupivacaine, Exparel that provide significantly longer analgesia than presently used single shot techniques protocols for extended nerve block analgesia.
文摘Background: Obesity, particularly in the setting of comorbid disease, presents a unique challenge. Clinicians are pursuing areas of multimodal analgesia in an effort to minimize narcotic dosages. Post-operatively, their pain management can be even more challenging, which includes appropriate use of narcotics in a patient that has a high probably of sleep apnea. Aim: To show that the use of liposomal bupivacaine (Exparel) can provide effective post-operative pain relief and decrease the use of post-operative narcotics. Case: We report on a 62 years old female with a history of hypertension, obesity and a greater than a 40 pack year history of smoking who presented for a modified radical mastectomy with a lymph node dissection. At the end of the case, the patient’s wound was infiltrated with both free bupivacaine and Exparel that minimized her need for post-operative narcotics. Conclusion: We believe that the use of extended release local anesthetics should be considered when there is a need to reduce the use of post-operative narcotics.
