5. Analgesia for Abdominal Surgery

  1. Ian Johnston4,
  2. William Harrop-Griffiths5 and
  3. Leslie Gemmell6
  1. Alex Grice1,
  2. Nick Boyd2 and
  3. Simon Marshall3

Published Online: 10 NOV 2011

DOI: 10.1002/9781118227978.ch5

AAGBI Core Topics in Anaesthesia

AAGBI Core Topics in Anaesthesia

How to Cite

Grice, A., Boyd, N. and Marshall, S. (2011) Analgesia for Abdominal Surgery, in AAGBI Core Topics in Anaesthesia (eds I. Johnston, W. Harrop-Griffiths and L. Gemmell), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118227978.ch5

Editor Information

  1. 4

    Raigmore Hospital, Inverness, UK

  2. 5

    Imperial College Healthcare NHS Trust, London, UK

  3. 6

    Wrexham Maelor Hospital, Wrexham, UK

Author Information

  1. 1

    Royal Devon and Exeter NHS, Foundation Trust, Exeter, UK

  2. 2

    Derriford Hospital, Plymouth, UK

  3. 3

    Musgrove Park Hospital, Taunton, UK

Publication History

  1. Published Online: 10 NOV 2011
  2. Published Print: 29 NOV 2011

ISBN Information

Print ISBN: 9780470658628

Online ISBN: 9781118227978

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Keywords:

  • abdominal surgery and analgesia;
  • epidural analgesia;
  • enhanced recovery programs;
  • 3rd National Audit Project (NAP 3);
  • real-time imaging;
  • intrathecal local anaesthetic;
  • rectus sheath block;
  • TAP block;
  • ilioinguinal, iliohypogastric blocks

Summary

• This chapter provides a brief description of various techniques that can be employed to provide analgesia following abdominal surgery including epidurals, spinals, rectus sheath catheters, transversus abdominus plane block, ilioinguinal/iliohypogastric block and paravertebral block.

• Epidural analgesia represents the main technique employed in the United Kingdom and produces a quality of analgesia against which all other techniques are judged. A recent national audit reinforced epidurals excellent safety profile but also noted the greatest proportion of complications arose in the colorectal group.

• Recent attention to enhanced recovery programs has encouraged clinicians to adopt alternative techniques that enable rapid mobilization and whilst some results are encouraging, further work is required to assess these techniques before widespread adoption can be recommended.

• Postoperative hypotension can be exacerbated by the choice of analgesia technique and may influence oxygen delivery to a surgical anastomosis.