Postoyerative Pain Control and Lung Function with Rectus Sheath Analgesia

Kim, Jong Rae; Choi, Ryung; Oh, Hung Kun

Abstract

Twenty patients for abdominal surgery chosen at random were studied for postoperative pain relief with rectus sheath analgesia and meperidine by intramuscular injection. We wished to determine the efficacy of this new method of regional analgesia and to make a comparison it with that of systemic narcotics. At operation after surture of the posterior rectus sheath a specially designed 17 gauge polyethylene tube was positioned within the rectus sheath so that it lay in close proximity to the nerves supplying the surgical wound. The tube was designed to ensure even and uniform distribution of the local analgesics (2% lidocain 5 ml about 6 times on 1 st 24 hrs and 3 times on next 24 hrs) and it was removed after 48 hrs. The rectus sheath analgesia group of 15 patients was compared to a mepridine (50 mg) group of 5 patients. The effect of rectus sheath analgesia on pain relief and the patients ability to cough, to take deep breaths and to sit up were assessed subjectively by the same physician and objectively by each patient. In both groups pulmonary functions were assessed by measurements of arterial gases, tidal volume, minute volume, frequency, vital capacity, timed vital capacity, and peak expiratory flow rate(%). These measurements were assessed before and after operation and on the first and second postoperative days. Rectus sheath analgesia was found to reduce the degree of postoperative lung dysfunction. It is recommended in all debilitated patient with existing airway disease. It is concluded that rectus sheath analgesia is a reliable and simple method of controlling postoperative abdominal pain.

Postoyerative Pain Control and Lung Function with Rectus Sheath Analgesia

Abstract

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