local in the wound

[charmcitygasman]

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Hey all. I am new here. Am a CA1. Anyways today I was doing a AAA endograft repair and at the end I asked the surgeon to infiltrate the incision with local. Pt with bad OSA and phtn and thought this would help avoid some narcs. Surgeon said he never does that because he read a study showing local in the wound did nothing to decrease narc requirements post op. Anyone here know of the study he was talking about or agree with him?

 

[nlfru]

Hey all. I am new here. Am a CA1. Anyways today I was doing a AAA endograft repair and at the end I asked the surgeon to infiltrate the incision with local. Pt with bad OSA and phtn and thought this would help avoid some narcs. Surgeon said he never does that because he read a study showing local in the wound did nothing to decrease narc requirements post op. Anyone here know of the study he was talking about or agree with him?

Ask yourself exactly how long that local is really going to last.

 

[charmcitygasman]

well if they used bupivicaine it could last a number of hours during which time we could fully wake pt and then carefully titrate narcs as needed

 

[12th man]

Somewhere lost in my brain, I thought the local infiltration was suppose to help wound healing...maybe not, can't remember and don't care that badly to look it up.

 

[lushmd]

I don't see the harm in doing it but I don't think that there's a big benefit to it either in this case since pain from an endovascular AAA repair should be pretty minimal. There are certain settings, such as laparoscopic procedures, where local infiltration of the incision sites is certainly effective.

 

[Idiopathic]

Somewhere lost in my brain, I thought the local infiltration was suppose to help wound healing...maybe not, can't remember and don't care that badly to look it up.

the data i have seen, which i will have to look up to cite, actually showed impaired wound healing with local infiltration (actually it was with surgical site "pain pump" placement, i believe)