الفهرس | Only 14 pages are availabe for public view |
Abstract The origin of pain from abdominal surgery is multifactorial, including a parietal (or somatic) component originating from the surgical incision and a visceral component originating from the peritoneum and the manipulation of the intra-abdominal structures. The somatic innervation of the anterior abdominal wall arises from the thoracolumbar spinal nerves (i.e., T6–L1). Morphine administration is the cornerstone of pain therapy, but acute tolerance after opioid exposure has been described as early as the immediate postoperative period. Enhanced recovery after surgery, which involves implementation of evidence-based multimodal procedure- specific perioperative care pathways, has been shown to improve postoperative outcome and reduce length of hospital stay. One of the major elements of a successful program for enhanced recovery after surgery is the provision of optimal postoperative analgesia to facilitate ambulation and rehabilitation therapy. |