TECHNICAL AND QUANTITATIVE ANALYSIS OF PAIN MANAGEMENT IN MAJOR SURGERIES USING REGIONAL ANESTHESIA WITH OPIOID-SPARING DRUGS

Resumen

The management of acute postoperative pain (APP) in major abdominal surgeries remains a critical challenge due to the adverse effects associated with opioid use, such as respiratory depression, nausea, vomiting, and decreased gastrointestinal motility. These complications underscore the need for alternative pain management strategies that minimize opioid dependence while ensuring effective analgesia. This study systematically reviews the opioid-sparing effects of regional anesthesia techniques, with a specific focus on the transversus abdominis plane (TAP) block and quadratus lumborum block (QLB). Both techniques are increasingly recognized as essential components of multimodal analgesia strategies, which aim to optimize postoperative recovery and reduce opioid-related complications. The findings reveal that TAP and QLB are highly effective in controlling postoperative pain, significantly decreasing opioid requirements and enhancing recovery outcomes. TAP block has demonstrated particular efficacy in reducing pain and opioid consumption in colorectal and bariatric surgeries, while QLB has shown promise in managing pain for more extensive abdominal procedures, offering prolonged analgesic effects. Despite their shared benefits, each technique presents unique efficacy profiles, which are influenced by factors such as surgical type, patient characteristics, and the choice of local anesthetic. These distinctions highlight the importance of tailoring regional anesthesia techniques to individual patient needs. This study also emphasizes the role of multimodal analgesic approaches that combine regional anesthesia with other non-opioid analgesics, such as ketamine and lidocaine, to further enhance pain control and minimize opioid use. Such approaches not only improve pain management but also contribute to faster recovery and fewer complications, such as postoperative nausea and delayed gastrointestinal transit. In conclusion, integrating regional anesthesia techniques like TAP and QLB into multimodal pain management protocols offers substantial benefits in reducing opioid consumption and enhancing postoperative recovery. Future research should focus on direct comparisons between regional techniques, their long-term effects, and their potential to reduce chronic pain recurrence, ensuring continued advancements in perioperative care.