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ESRA19-0164 Analgesia with an interfascial catheter after laparoscopic gastric surgery

Background and aims Postoperative acute pain management after undergoing laparoscopic surgery has traditionally been carried out with standard analgesia, using both anti-inflammatory and opiate drugs. Placing an interfascial wound catheter intraoperatively in order to administer local anaesthetics through it could optimize the pain control. This analgesic technique could lead to a reduction in postoperative morphine requirements. Our main objective was to determine the efficacy of a multimodal analgesia using an interfascial catheter for postoperative acute pain control after laparoscopic gastric surgery. Methods We analysed a series of patients with an interfascial wound catheter after gastric laparoscopic surgery. A continuous infusion of 0.25% levobupivacaine (8 mL/h) was administered through the catheter during 48 hours after surgery. As additional analgesia, anti-inflammatory drugs (metamizole or ibuprofen) and acetaminophen were used, and parenteral morphine bolus as rescue analgesia. Results Of the 12 patients that were included, 66.6% had an effective analgesia with no need of morphine at all, whilst 36.3% required low doses of morphine during the first 24 hours (3–6 mg of morphine). No complications or adverse effects associated with the wound catheter placing technique were observed. Conclusions During the first 48 hours after laparoscopic gastric surgery, a multimodal analgesia with continuous infusions of local anaesthetics through interfascial catheters can be useful for postoperative acute pain control. In addition, the reduction of morphine consumption avoids adverse effects associated with opiate drugs and leads to shorter hospital length of stay. Finally, this analgesic technique seems to be simple and safe, with no adverse effects associated. Abstract ESRA19-0164 Table 1 Results of morphine requirments