Chen KH, Kang MY, Chang YT, Huang SY, Wu YS. Enhancing postoperative pain control by surgically-initiated rectus sheath block in abdominal aortic aneurysm open repair: A case report. World J Clin Cases 2025; 13(6): 100673 [PMID: 40012827 DOI: 10.12998/wjcc.v13.i6.100673]
Corresponding Author of This Article
Sheng-Yang Huang, MD, PhD, Assistant Professor, Director, Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, No. 1650, Section 4, Taiwan Boulevard, Situn District, Taichung 407219, Taiwan. drugholic@vghtc.gov.tw
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
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Chen KH, Kang MY, Chang YT, Huang SY, Wu YS. Enhancing postoperative pain control by surgically-initiated rectus sheath block in abdominal aortic aneurysm open repair: A case report. World J Clin Cases 2025; 13(6): 100673 [PMID: 40012827 DOI: 10.12998/wjcc.v13.i6.100673]
Kuan-Hua Chen, Ming-Yuan Kang, Yung-Szu Wu, Center for Cardiovascular Disease, Taichung Veterans General Hospital, Taichung 407219, Taiwan
Yi-Ting Chang, Department of Anesthesiology, Taichung Veterans General Hospital, Taichung 407219, Taiwan
Sheng-Yang Huang, Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung 407219, Taiwan
Sheng-Yang Huang, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
Sheng-Yang Huang, Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung 402202, Taiwan
Co-corresponding authors: Sheng-Yang Huang and Yung-Szu Wu.
Author contributions: Chen KH contributed to writing original draft, review and editing, conceptualization, methodology, formal analysis; Kang MY and Chang YT contributed to conceptualization, methodology; Wu YS contributed to writing, review and editing, conceptualization, methodology; Huang SY contributed to writing, review and editing, conceptualization, methodology, funding acquisition, project administration; All authors have read and approved the final manuscript.
Supported by the Taichung Veterans General Hospital, No. TCVGH-1125401B.
Informed consent statement: The patient of this report provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Sheng-Yang Huang, MD, PhD, Assistant Professor, Director, Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, No. 1650, Section 4, Taiwan Boulevard, Situn District, Taichung 407219, Taiwan. drugholic@vghtc.gov.tw
Received: August 22, 2024 Revised: September 27, 2024 Accepted: November 6, 2024 Published online: February 26, 2025 Processing time: 94 Days and 17.6 Hours
Abstract
BACKGROUND
Abdominal aortic aneurysm (AAA) repair often involves significant postoperative pain, traditionally managed with systemic opioids, which can cause undesirable side effects. This case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA repair.
CASE SUMMARY
A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA, which had grown from 3.4 cm to 4.3 cm over 14 months. A rectus sheath block was initiated surgically for postoperative pain control. The patient reported low pain scores and did not require systemic intravenous opioids, enabling early ambulation and discharge on postoperative day seven without complications. By preventing complications of systemic opioids, the method indicating a promising direction for postoperative pain management in major vascular surgeries.
CONCLUSION
Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.
Core Tip: This case report highlights the successful use of a surgically-initiated rectus sheath block for postoperative pain management in a patient undergoing elective abdominal aortic aneurysm repair. The technique provided effective analgesia without the need for systemic opioids, enabling early ambulation and discharge on postoperative day seven. The rectus sheath block offers a promising alternative for pain control in abdominal surgeries, minimizing opioid-related side effects. Further research is needed to validate its safety and efficacy in larger patient cohorts.
