Opioid-sparing measures for laparoscopic-assisted segmental colectomy
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McGowan, Aleen Joy, DNP (c)
- Sigma Affiliation
- Unknown
- Contributor Affiliation(s)
- Samford University, Birmingham, Alabama, USA
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Abstract
Emphasis on opioid sparing multimodal analgesia and anesthesia has encouraged practitioners to become adept in the placement and use of complex regional blocks. Studies indicate that transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) provide adequate and prolonged analgesia after invasive abdominal and pelvic procedures.
A laparoscopic-assisted right hemicolectomy and sigmoid colon resection performed on a 70-year old female was managed using general anesthesia, isoflurane, intravenous (IV) rocuronium, and IV fentanyl. An ultrasound guided TAPB was performed through a posterior approach following the closure of the incision. A total of 20 ml of plain bupivacaine 0.25 % was administered on each side of the abdomen to provide full analgesic coverage of the anterior abdominal wall. The procedure concluded with a total of 150 mcg of fentanyl IV.
Twenty-four hours post-surgery, the patient had received a total IV medications of fentanyl 100 mcg, ketorolac 90 mg, acetaminophen 2 grams, hydromorphone 1.5 mg, and meperidine 50 mg. Patient-controlled analgesia was not required for pain management as is often needed after this type of surgery. Postoperative day (POD) three showed fentanyl 50 mcg IV and meperidine 100 mg IV. The fourth POD record reported a total IV dose of fentanyl 50 mcg and meperidine 50 mg. The patient was discharged home on POD five on oral tramadol hydrochloride.
Repository Posting Date
2021-03-24T17:08:56Z
Type Information
Type | Poster |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Category Information
Evidence Level | Literature Review |
Research Approach | Translational Research/Evidence-based Practice |
Keywords | Nerve Block; Postoperative Analgesia; Colorectal Surgery |
Degree Information
Grantor | Samford University |
Advisor | Ledbetter, Maria; Rankin, Heather |
Level | DNP |
Year | 2021 |
Conference Information
Name | Ida Moffett School of Nursing DNP Poster Presentation |
Host | Samford University |
Location | Birmingham, Alabama, USA |
Date | 2021 |
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