question-icon

What Causes Pain In The Abdominal Wall After Colorectal Surgery?

default
Posted on Mon, 17 Oct 2016
Question: I'm having a tumor removed from my colon. They want to use a new procedure called tap which thry insert two needles in my stomach plus use ketamine. never heard of tap and want something else instead of ketamine. I was already prepped for surgery and had the tap done, but my potassium level was 2 so surgery was called off. after the tap wore off, I,m having cramped where the needles went in between the muscles. Is this a side effect. Facing surgery again Wed,\.
doctor
Answered by Dr. Dr. Ivan Romich (34 minutes later)
Brief Answer:
I suggest conventional analgesia

Detailed Answer:
Hi and welcome.

Yes, this is so called Transversus abdominal plane block and this is relatively new method to reduce post-operative pain in abdominal wall. I don't think that potassium levels are caused by this, but also I don't see a reason for TAP since postoperative pain may be controlled by conventional analgetics only and I don't think TAP is necessary, especially considering that it may have some complications.

The most important step is to perform tumor resection surgery now, I don't suggest some compromises with new methods. This is my opinion.

Let me know if there's any further queries.

Wish you good health.
Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Dr. Ivan Romich (1 hour later)
m.y low potassium problem was discovered after my first colonostomy. The tumor is huge and will require me to wear an ostomy bag the rest of my life. I talked with a nurse from surgeons office and told her of the pain I'm having ever since the tap wore off. I was told the tap was to help with the pain after surgery and that it would help me get up and walk that day. She also said 100's of people have had it with no side effects. I disagree with her on that. They also told me I would received a small dose of ketamine that has a small side effect of hallucinations. The reason was given to avoid using morphine because of it's side effect, constipation. I have fibormaligia and IBS so I've had diarrhea for the last 9yrs. so constipation is not a problem for me. I don't want the tap or ketamine. do I have the right to say no? I've had many operations and never had a problem. So what do you suggest I use for postop pain.

don't know what conventional analgetics is. I have Percocet for when I have flare ups. don't want to get hooked on them so I only take it when I can't move and the pain is a 10.
doctor
Answered by Dr. Dr. Ivan Romich (9 hours later)
Brief Answer:
hi

Detailed Answer:
Yes, you you can refuse such analgesia course.
This is not conventional method, and by my opinion, it should be used in selected cases, where extreme postoperative pain is expected. Colon resection with colostomy is not one of it and it can be managed by usual analgesia, with tramadol ,paracetamol and diclofenac for example. Also, morphium based medications side effects may be prevented with appropriate diet and laxatives.
So I simply dont see why to force TAP in this case.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
Answered by
Dr.
Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13877 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

152 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Causes Pain In The Abdominal Wall After Colorectal Surgery?

Brief Answer: I suggest conventional analgesia Detailed Answer: Hi and welcome. Yes, this is so called Transversus abdominal plane block and this is relatively new method to reduce post-operative pain in abdominal wall. I don't think that potassium levels are caused by this, but also I don't see a reason for TAP since postoperative pain may be controlled by conventional analgetics only and I don't think TAP is necessary, especially considering that it may have some complications. The most important step is to perform tumor resection surgery now, I don't suggest some compromises with new methods. This is my opinion. Let me know if there's any further queries. Wish you good health. Regards