Abstract
Surgical procedures inside the abdominal cavity are usually associated with intensive postoperative pain. Good-quality analgesia shortens the length of hospital stay, decreases the costs of treatment, and reduces postoperative complications.
Continuous epidural analgesia with the mixture of local anesthetics and opioids remains the method of choice during surgical procedures. If this method is not feasible, multimodal analgesia with a combination of strong opioids, non-opioid analgesics, and eventually intravenous infusion of lidocaine is indicated.
During the postoperative period, continuous epidural analgesia, even patient-controlled is a suitable method of pain relief. Other options include intravenous patient-controlled analgesia with strong opioids, a combination of opioids and non-opioid analgesics, or multimodal non-opioid analgesia, where paracetamol, metamizole, nonsteroidal anti-inflammatory drugs, and selective inhibitors of cyclooxygenase 2 may be employed.
Systemic analgesia may be supplemented also with the techniques of abdominal wall regional blockades, such as rectus sheath block, transversus abdominis plane block, erector spinae block, or continuous wound infiltration.