Invited Discussion on: Evaluation of the Effect of Erector Spinae Plane Block in Patients Undergoing Belt Lipectomy Surg
- PDF / 212,589 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 43 Downloads / 170 Views
EDITOR’S INVITED COMMENTARY
Invited Discussion on: Evaluation of the Effect of Erector Spinae Plane Block in Patients Undergoing Belt Lipectomy Surgery Mauricio E. Perez1 • Alfredo E. Hoyos2
Received: 25 August 2020 / Accepted: 25 August 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Level of evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Introduction Obesity has been acknowledged as one of the most common diseases from the twenty-first century, as its incidence has grown exponentially in the recent decades, even among the pediatric population, most likely following the increased sedentarism and the high-calorie diet that are extremely common nowadays [1, 2]. As a consequence, the demand for post-bariatric surgery and excisional body contour surgeries has increased due to the new technologies that aid in decreasing the rate of complications but, at the same time, improve the postoperative look of this new pool of individuals, to whom liposuction is definitely not enough. Several complaints surround the preoperative and postoperative management of this type of procedure. Pain is one of those great concerns from both the surgeon and the patient, which is, by far, the most common and bothersome symptom after surgery. Different recommendations have been made to achieve optimal pain management following aesthetic surgery procedures [3], since poor pain control is
associated with worse clinical outcomes and usually negative perceptions for the patient. Truth to be told, narcotics should be avoided or used at a minimum, which is why plastic surgeons and anesthesiologists must be proficient in multimodal analgesia. One of the key points while doctoring severe pain is to acknowledge and plan ahead for its potential severity and quality, in order to prepare our treatment with adjuvants like local anesthetics, regional blocks, and epidurals, which can be actually used prior to the procedure. Pain is usually decreased with rest and immobilization, which in turn increases the risk of VTE in postoperative patients, even more as evidence supporting chemoprophylaxis has been somehow debatable. Pannucci et al. 4] found that it did not significantly reduce VTEs in plastic surgery patients with Caprini scores C 8, while the bleeding risk was in fact increased. Swanson [5] detailed some recommendations based on recent data about routine anticoagulation for VTE prevention among plastic surgery patients, from which one could conclude that every patient must be individualized and alternative measures (sequential compression pumps and stockings) plus premature diagnosis remain the best alternatives, and perhaps, adequate pain control would indirectly decrease VTE risk by promoting early mobilization and providing a faster recovery.
Up-to-date Revie
Data Loading...
