Eur J Plast Surg (2015) 38:257–266 DOI 10.1007/s00238-015-1098-x REVIEW Review of the analgesia options for patients undergoing TRAM and DIEP flap breast reconstruction 1 1 1 2 Andreas Shiatis & Hawys Lloyd-Hughes & Amit Pabari & Angus Hayward & Ash Mosahebi Received: 22 March 2015 /Accepted: 14 April 2015 /Published online: 31 May 2015 Springer-Verlag Berlin Heidelberg 2015 Abstract autologous breast reconstruction including benefits, lim- Background The mainstay of autologous breast reconstruc- itations, indications and patient outcomes. tion involves abdominal wall-based tissue transfer in the form Results The literature search yielded a total of 31 articles identi- of free or pedicled TRAMs or more recently free DIEP fying 6 analgesic techniques: patient-controlled analgesia (PCA), flaps. Although excellent choices for breast reconstruc- epidural analgesia, continuous wound infusion with local anaes- tion, all of these techniques do have significant morbid- thetic, intermittent boluses of local anaesthetic, transverse ity when considering donor-site pain. This can lead to abdominis plane (TAP) blocks and slow release bupivicaine. other complications such as reduced mobility, deep vein Conclusions Various anaesthetic techniques are used to re- duce postoperative mortality in autologous breast reconstruc- thrombosis, pulmonary emboli, respiratory infections, heavy opiate use, constipation and prolonged in hospital tion.
European Journal of Plastic Surgery – Springer Journals
Published: May 31, 2015
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