الفهرس 
Post-operative painOnly 14 pages are availabe for public view
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Abstract
Unceasing efforts have been tried to control the postoperative pain
effectively. Multimodal techniques are consisted of combinations of opioids
(either systemically or neuraxially), nonsteroidal anti-inflammatroy drugs,
paracetamol, regional and peripheral nerve blocks are currently used for pain
control after surgery. There are concerns with regard for the potential of
systemically administered opioids to cause nausea, vomiting, drowsiness and
respiratory depression Furthermore; epidural analgesia can develop
hypotension, vomiting, urine retention in addition to serious complications
such as epidural abscess, meningitis, vertebral canal hematoma, spinal cord
ischemia and paraplegia.
Recently, peripheral nerve blocks have been implemented to alleviate
the problems above in addition to controlling the postoperative pain
effectively. The use of ultrasound-guided nerve blocks offers the advantage of
direct visualization of the needle and the anatomical structures. Therefore, one
can see real-time images during the procedure and inject drugs more accurately
and rapidly into the target site than with nerve stimulator or blindly blocking
peripheral nerves. So, this enhances the safety and efficacy of the procedure.
Transversus abdominis plane (TAP) block is an effective method of
blocking the sensory afferents supplying the anterior abdominal wall. There are
two types of TAP block (posterior and subcostal). Posterior TAP block has
been shown to provide analgesia after lower abdominal surgery but Subcostal
TAP block has been reported to provide analgesia for incisions extending
above the umbilicus.
Rectus sheath block is performed by administration of local anesthetic
into the space between the rectus muscle and posterior rectus sheath to block.