Enhancing postoperative pain control by surgically-initiated rectus sheath block in abdominal aortic aneurysm open repair: A case report.

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL World Journal of Clinical Cases Pub Date : 2025-02-26 DOI:10.12998/wjcc.v13.i6.100673

Kuan-Hua Chen, Ming-Yuan Kang, Yi-Ting Chang, Sheng-Yang Huang, Yung-Szu Wu

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Abstract

Background: Abdominal aortic aneurysm (AAA) repair often involves significant postoperative pain, traditionally managed with systemic opioids, which can cause undesirable side effects. This case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA repair.

Case summary: A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA, which had grown from 3.4 cm to 4.3 cm over 14 months. A rectus sheath block was initiated surgically for postoperative pain control. The patient reported low pain scores and did not require systemic intravenous opioids, enabling early ambulation and discharge on postoperative day seven without complications. By preventing complications of systemic opioids, the method indicating a promising direction for postoperative pain management in major vascular surgeries.

Conclusion: Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.

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腹主动脉瘤切开修复术中外科启动的直肌鞘阻滞加强术后疼痛控制一例报告。

背景：腹主动脉瘤（AAA）的修复通常涉及明显的术后疼痛，传统上使用全身阿片类药物治疗，这可能导致不良的副作用。本病例报告探讨了手术启动直肌鞘块与导管-针组件在AAA修复疼痛管理中的新应用。病例总结：一名67岁的高血压女性患者，既往主动脉夹层，在14个月的时间里从3.4厘米增长到4.3厘米，她接受了选择性的开放修复术。术中采用直肌鞘阻滞以控制术后疼痛。患者报告疼痛评分低，不需要全身静脉注射阿片类药物，能够在术后第7天早期下床和出院，无并发症。通过预防全身阿片类药物的并发症，该方法为大血管手术术后疼痛管理指明了一个有希望的方向。结论：手术启动的直肌鞘阻滞是治疗AAA修复术后疼痛的有价值的工具。

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World Journal of Clinical Cases Medicine-General Medicine

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期刊介绍： The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.