Preperitoneal Permanent Anesthesia for Postoperative Pain Management After Laparoscopic Surgery.

The preperitoneal permanent anesthesia (PPA) is a novel player for postoperative pain management after laparoscopic surgery. A multi-holed catheter is implanted in the preperitoneal space at the end of the surgical procedure. Local anesthetics can be applied through this catheter and easily spread by gravity to subcostal and diaphragm areas. Based on the results of this feasibility project a reduction of opiates after surgical injury can be observed. Furthermore an elimination of diaphragmatic post laparoscopic complaints has been shown. PPA reduces or even eliminates the postsurgical usage of opiates in comparison to opioid-based patient controlled anesthesia (PCA) and peridural anesthesia catheters (PDC). This improves the respiratory related complications especially for patients with obesity or obstructive sleep apnea. The usage of local anesthesia in the preperitoneal space is safe and easy to apply. In this feasibility study we present a simple technique for PPA expecting to develop it into a new standard in pain management for non-opioid-based anesthesia for patients after laparoscopic surgery.

Johanna Hidding, Alexander Frank. Viktor von Ehrlich-Treuenstatt, Jens Werner, Konrad Karcz

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