Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P029: EFFICACY OF EPIDURAL PAIN MANAGEMENT FOR COMPLEX ABDOMINAL WALL RECONSTRUCTION IN THE ERA OF THE OPIOID CRISIS: A PROSPECTIVE STUDY
James K Choi, MD, MA; Rifat Latifi, MD, FACS, FICS; Kendall Post; Shekhar Gogna, MD; Abbas Smiley, MD, PhD; Jeff L Xu, MD; Westchester Medical Center - New York Medical College
Background: Post-operative pain management of patients undergoing complex abdominal wall reconstruction (CAWR) in the era of growing concerns of an opioid epidemic is difficult. The objective of this study was to examine the role of epidural anesthesia in reducing post-operative narcotic use in CAWR patients.
Methods: This was a prospective study of CAWRs from April 2016 to March 2020. All CAWRs were performed using the perforator-sparing open technique with a biological mesh. Patients with an extended ICU length of stay greater than 4 days were excluded from the study. Patients were divided into two groups: perioperative epidural anesthesia group (EG), and those without an epidural anesthesia group (NEG). Demographics, post-operative complications, numeric rating scale (NRS) for pain, type of pain management, and their length of use were analyzed.
Results: A total of 156 patients were studied. Patients in the EG group were significantly younger than in the NEG group (56.4 years old vs. 61.4 years old, respectively, p = 0.02). There was no significant difference in the average post-operative NRS pain score between the two groups. However, patients in EG had a significantly shorter number of days on oral (PO) oxycodone than NEG (3.8 days (SD = 3.9) vs. 5.4 days (SD = 5.0), p = 0.03), and a significantly longer number of days on Tylenol PO (4.5 days (SD = 4.4) vs. 3.1 days (SD = 3.3), p = 0.03). Moreover, there was no significant difference between the two groups in terms of post-operative wound infections, wound necrosis, or seroma formation.
Conclusion: Perioperative epidural analgesia decreased the number of post-operative days on PO oxycodone, and did not contribute to the post-operative morbidity or subjective pain in CAWR.
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