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Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Local anesthetic wound infiltration (WI) provides anesthesia for minor surgical procedures and improves postoperative analgesia as part of multimodal analgesia after general or regional anesthesia. Although pre-incisional block is preferable, in practice WI is usually done at the end of surgery. WI...

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Autores principales: Stamenkovic, Dusica M., Bezmarevic, Mihailo, Bojic, Suzana, Unic-Stojanovic, Dragana, Stojkovic, Dejan, Slavkovic, Damjan Z., Bancevic, Vladimir, Maric, Nebojsa, Karanikolas, Menelaos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537195/
https://www.ncbi.nlm.nih.gov/pubmed/34682777
http://dx.doi.org/10.3390/jcm10204659
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author Stamenkovic, Dusica M.
Bezmarevic, Mihailo
Bojic, Suzana
Unic-Stojanovic, Dragana
Stojkovic, Dejan
Slavkovic, Damjan Z.
Bancevic, Vladimir
Maric, Nebojsa
Karanikolas, Menelaos
author_facet Stamenkovic, Dusica M.
Bezmarevic, Mihailo
Bojic, Suzana
Unic-Stojanovic, Dragana
Stojkovic, Dejan
Slavkovic, Damjan Z.
Bancevic, Vladimir
Maric, Nebojsa
Karanikolas, Menelaos
author_sort Stamenkovic, Dusica M.
collection PubMed
description Local anesthetic wound infiltration (WI) provides anesthesia for minor surgical procedures and improves postoperative analgesia as part of multimodal analgesia after general or regional anesthesia. Although pre-incisional block is preferable, in practice WI is usually done at the end of surgery. WI performed as a continuous modality reduces analgesics, prolongs the duration of analgesia, and enhances the patient’s mobilization in some cases. WI benefits are documented in open abdominal surgeries (Caesarean section, colorectal surgery, abdominal hysterectomy, herniorrhaphy), laparoscopic cholecystectomy, oncological breast surgeries, laminectomy, hallux valgus surgery, and radical prostatectomy. Surgical site infiltration requires knowledge of anatomy and the pain origin for a procedure, systematic extensive infiltration of local anesthetic in various tissue planes under direct visualization before wound closure or subcutaneously along the incision. Because the incidence of local anesthetic systemic toxicity is 11% after subcutaneous WI, appropriate local anesthetic dosing is crucial. The risk of wound infection is related to the infection incidence after each particular surgery. For WI to fully meet patient and physician expectations, mastery of the technique, patient education, appropriate local anesthetic dosing and management of the surgical wound with “aseptic, non-touch” technique are needed.
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spelling pubmed-85371952021-10-24 Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review Stamenkovic, Dusica M. Bezmarevic, Mihailo Bojic, Suzana Unic-Stojanovic, Dragana Stojkovic, Dejan Slavkovic, Damjan Z. Bancevic, Vladimir Maric, Nebojsa Karanikolas, Menelaos J Clin Med Review Local anesthetic wound infiltration (WI) provides anesthesia for minor surgical procedures and improves postoperative analgesia as part of multimodal analgesia after general or regional anesthesia. Although pre-incisional block is preferable, in practice WI is usually done at the end of surgery. WI performed as a continuous modality reduces analgesics, prolongs the duration of analgesia, and enhances the patient’s mobilization in some cases. WI benefits are documented in open abdominal surgeries (Caesarean section, colorectal surgery, abdominal hysterectomy, herniorrhaphy), laparoscopic cholecystectomy, oncological breast surgeries, laminectomy, hallux valgus surgery, and radical prostatectomy. Surgical site infiltration requires knowledge of anatomy and the pain origin for a procedure, systematic extensive infiltration of local anesthetic in various tissue planes under direct visualization before wound closure or subcutaneously along the incision. Because the incidence of local anesthetic systemic toxicity is 11% after subcutaneous WI, appropriate local anesthetic dosing is crucial. The risk of wound infection is related to the infection incidence after each particular surgery. For WI to fully meet patient and physician expectations, mastery of the technique, patient education, appropriate local anesthetic dosing and management of the surgical wound with “aseptic, non-touch” technique are needed. MDPI 2021-10-11 /pmc/articles/PMC8537195/ /pubmed/34682777 http://dx.doi.org/10.3390/jcm10204659 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Stamenkovic, Dusica M.
Bezmarevic, Mihailo
Bojic, Suzana
Unic-Stojanovic, Dragana
Stojkovic, Dejan
Slavkovic, Damjan Z.
Bancevic, Vladimir
Maric, Nebojsa
Karanikolas, Menelaos
Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review
title Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review
title_full Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review
title_fullStr Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review
title_full_unstemmed Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review
title_short Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review
title_sort updates on wound infiltration use for postoperative pain management: a narrative review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537195/
https://www.ncbi.nlm.nih.gov/pubmed/34682777
http://dx.doi.org/10.3390/jcm10204659
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