Path towards Pain-Free Abdominoplasty: A Retrospective Observational Study of Field Block for Postoperative Pain Management Following Abdominoplasty

Background: Abdominoplasty, a common aesthetic procedure, is frequently associated with moderate to severe postoperative pain. Multimodal analgesia, including local anaesthetic infiltration, aims to improve recovery and reduce opioid use. Although bupivacaine and ropivacaine are widely utilised local anaesthetics, the benefit of combining ropivacaine with corticosteroids like methylprednisolone in abdominoplasty remains underexplored. Objective: To compare postoperative pain control and mobility among three analgesic strategies: no local anaesthetic, bupivacaine alone and ropivacaine combined with methylprednisolone. Methods: This retrospective, single-centre cohort study included patients who underwent primary abdominoplasty between January 2021 and May 2025. Patients were categorised into three groups: no local anaesthetic (Group N, n = 48), bupivacaine 0.25% (Group B, n = 93) and ropivacaine 0.2% with methylprednisolone 40 mg (Group R, n = 52). Postoperative pain was assessed using the visual analogue scale (VAS) at 2–48 h. A 5-point scale assessed mobility within 48 h after abdominoplasty. Group comparisons were performed using analysis of variance (ANOVA). Results: Group R demonstrated significantly lower mean VAS scores at all time points ( P < .001) compared with Groups B and N and superior mobility scores, indicating faster return to ambulation. Conclusions: Ropivacaine combined with methylprednisolone provides improved postoperative pain control and earlier functional recovery, compared to bupivacaine alone or no local anaesthetics. These findings suggest a potential role for corticosteroid-adjuvant local infiltration within multimodal, opioid-sparing analgesia protocols for abdominoplasty, warranting further prospective evaluation.