The transversus abdominis plane (TAP) block provides analgesia to the parietal peritoneum as well as the skin and muscles of the anterior abdominal wall. These same muscles and skin are operated on during an abdominoplasty. The purpose of this study was to determine whether the use of the TAP block will lead to reduced use of narcotics during the acute postoperative (PO) period (PO day 1 and PO 1 week). The study used a prospective, comparative design. Twenty women between 25 and 65 years of age who underwent abdominoplasty with core liposuction were recruited to participate in this study. All women were given the same PO pain medication Percocet 7.5/325 mg (1-2 tabs by mouth Q4-6 hours PRN pain #20) and Valium 2 mg (1-3 tabs by mouth Q4-6 hours PRN pain #40) at the time of surgery. The women were randomly divided into 2 groups: 10 women received local anesthetic infiltrated along the rectus plication and along the edges of the incision and 10 women received a TAP block (15 cc of 0.25% Bupivacaine with 8 mg of Decadron per side) placed under ultrasound guidance prior to the start of the procedure in conjunction with the local anesthetic along the rectus plication. Each woman was asked to record the number of narcotic pills consumed during the first 24 hours and during the first week. Data from the 2 groups were compared to determine the number of narcotics consumed during the acute PO period. The mean age of participants was 43.8 years (range: 31-63 years) in the treatment group and 38.8 years (range: 26-56 years) in the control group. The mean number of narcotics used during the first 24 hours in the treatment group was 1.95 (1.5) pills, with several women requiring no narcotics within the first 24 hours. The mean number of narcotics used during the first 24 hours in the control group was 4.6 (2.3) pills. The mean number of narcotics used during the first PO week in the treatment group was 7.15 (7.26) pills, with several women requiring no narcotics during the first PO week. The mean number of narcotics used during the first PO week in the control group was 18.7 (7.7), with 1 woman requiring 38 narcotic pills during that first PO week. Statistically significant differences were found between groups ( P = .006) at 24 hours PO and ( P = .01) at 1 week. Our results suggested that receiving a TAP block prior to the start of the procedure significantly reduced the number of narcotics used during the acute PO period.

Manual lymphatic drainage (MLD) performed by lymphatic massage, in the postoperative period after abdominoplasty with core liposuction, may promote a faster resolution of edema. The purpose of this study was to determine the benefits of MLD by assessing the amount of edema at 6 and 8 weeks after abdominoplasty with core liposuction in patients who did or did not receive MLD for 3 weeks. The study used a prospective, comparative design. A total of 20 women aged 30 to 60 years, who underwent an abdominoplasty and core liposuction, were recruited from 2 clinics. Participants were divided into 2 equal groups based on clinic location. All participants wore a standard compression garment for 8 weeks after surgery. Starting at 6 weeks after surgery, the treatment group was treated by a certified lymphedema specialist twice a week for 3 weeks (6 visits). At 6 and 8 weeks after surgery, the waist circumferences of all participants were measured in 3 locations: at the navel, 3 cm above the navel, and 3 cm below the nave. Data from the 2 groups were compared to determine the change in edema. The mean age of participants was 41.6 years (range = 32-59 years) in the treatment group and 40.8 years (range = 30-59 years) in the control group. The mean (SD) reduction in edema between weeks 6 and 8 in the treatment group was 9.8 cm; 1 participant lost 18.2 cm during that period. The mean (SD) reduction in edema between weeks 6 and 8 in the control group was 6.6 cm; a few participants lost 12.0 cm during that period. No differences in mean reductions were found between groups ( P = .11). No differences were found between groups based on clinic location ( P = .84). Our results suggested that receiving MLD after abdominoplasty and core liposuction reduced edema more than the standard compressive garments, but not by a statistically significant amount. Furthermore, differences in the study groups were not dependent on clinic location.

No abstract

No abstract