Our Summary

This study looked at the effectiveness of different types of nerve blocks – a kind of anesthetic – used in tummy tuck surgeries. The researchers wanted to find out if any of these nerve blocks were more effective than others in helping patients feel more comfortable after surgery. They looked at a number of different factors, including the amount of opioid painkillers used, pain levels, the time it took for patients to start moving around again, how long they stayed in the recovery room, and when they first asked for pain relief.

The team reviewed 191 studies and found that all the different types of nerve blocks they looked at – TAP, RS, pararectus + ilioinguinal/iliohypogastric, and intercostal – were effective in reducing the use of opioid painkillers. However, one type, quadratus lumborum, did not have this effect.

In comparing the different nerve blocks, the researchers found that TAP was more effective than RS and pararectus + ilioinguinal/iliohypogastric. They suggest that if ultrasound (which is often used to guide the administration of nerve blocks) is not available, doctors should consider using TAP, which can be administered using direct visualization.

FAQs

  1. What types of nerve blocks were considered in this study on tummy tuck surgeries?
  2. Which nerve block was found to be less effective in reducing the use of opioid painkillers in the study?
  3. Was there any recommendation made by the researchers regarding the use of a specific nerve block when ultrasound is unavailable?

Doctor’s Tip

Overall, the findings suggest that using certain types of nerve blocks, such as TAP, can help reduce the need for opioid painkillers after abdominoplasty surgery. This can lead to a more comfortable recovery process and potentially fewer side effects associated with opioid use. It is important to discuss with your doctor the best options for pain management before and after your surgery to ensure a smooth recovery.

Suitable For

Patients who are typically recommended for abdominoplasty, also known as a tummy tuck, include those who have excess skin and fat in the abdominal area that does not respond to diet and exercise. This can be due to factors such as weight loss, pregnancy, or aging. Patients who have weakened abdominal muscles, resulting in a protruding abdomen, may also be recommended for abdominoplasty. Additionally, individuals who have lost skin elasticity and have sagging skin in the abdominal area may benefit from this procedure. It is important for patients to have realistic expectations and be in good overall health before undergoing abdominoplasty.

Timeline

Before abdominoplasty, a patient typically undergoes a consultation with a plastic surgeon to discuss their goals and expectations for the surgery. They may also undergo pre-operative tests and evaluations to ensure they are healthy enough for the procedure. On the day of surgery, the patient will be given general anesthesia before the abdominoplasty procedure is performed.

After abdominoplasty, the patient will wake up in a recovery room where they will be monitored closely for any complications. Pain medication will be provided to manage discomfort, and the patient will be encouraged to start moving around as soon as possible to prevent blood clots and promote healing. The patient will be given instructions on how to care for their incision site, as well as information on when to follow up with their surgeon for post-operative appointments.

In the weeks following abdominoplasty, the patient will experience swelling, bruising, and discomfort, which will gradually improve over time. They will be advised to avoid strenuous activities and lifting heavy objects for several weeks to allow their body to heal properly. As the swelling subsides and the incision site heals, the patient will start to see the final results of their abdominoplasty surgery.

What to Ask Your Doctor

  1. What type of nerve block will be used during my abdominoplasty surgery?
  2. How will the nerve block help with pain management during and after the surgery?
  3. Are there any potential risks or side effects associated with the nerve block?
  4. How long will the nerve block provide pain relief after the surgery?
  5. Will I still need to take opioid painkillers after the surgery, even with the nerve block?
  6. How will the nerve block affect my recovery time and ability to move around after the surgery?
  7. If ultrasound is not available, will the TAP nerve block be used as a preferred alternative based on the findings of this study?
  8. How will the choice of nerve block impact my overall experience and comfort during the recovery process?
  9. Are there any specific precautions or considerations I should keep in mind regarding the nerve block and my post-operative care?
  10. Can you provide more information or resources about the different types of nerve blocks and their effectiveness in abdominoplasty surgeries?

Reference

Authors: Vonu PM, Campbell P, Prince N, Mast BA. Journal: Aesthet Surg J. 2020 Oct 24;40(11):1208-1215. doi: 10.1093/asj/sjz313. PMID: 31680144