Infiltration of the abdominal wall with local anaesthetic after total abdominal hysterectomy has no opioid-sparing effect

Klein, Julianne; Heaton, J P; Thompson, J. P.; Cotton, B.R.; Davidson, A. C.; Smith, G.

doi:10.1093/oxfordjournals.bja.a013412

Cited by 58 publications

(32 citation statements)

References 1 publication

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“…This study showed an elevated VAS score in group C above 30 mm until 8 h, which means there was significant postoperative pain even for LA. Various attempts have been made to reduce the postoperative pain of laparoscopic surgery, including intraperitoneal instillation [19], preincisional infiltration [20], intraperitoneal nebulization [21], epidural administration, and continuous intravenous infusion of local anesthetics [16]. Many clinicians have demonstrated that intraperitoneal instillation of local anesthetic reduces postoperative pain and the need for analgesic medications [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal and intravenous lidocaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study

et al. 2011

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Intravenous lidocaine injection is as effective as intraperitoneal instillation for reducing pain and fentanyl consumption. The major benefit of intravenous injection is that this is an easily and universally applicable procedure compared to that of intraperitoneal instillation. Lidocaine intravenous administration is a better alternative for reducing the pain of patients who are undergoing laparoscopic surgery.

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Section: Discussionmentioning

confidence: 99%

Intraperitoneal and intravenous lidocaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study

et al. 2011

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“…Investigators also examined its efficacy in laparoscopic surgery with promising results [5][6][7][8][9][10]. With laparotomy, however, the effect of PLA was not observed [13,17]. Investigators have suggested that the effects of PLA vary according to the type of surgery, perhaps due to the visceroperitoneal nociception which is not affected by peripheral incisional anesthetic injection [12].…”

Section: Discussionmentioning

confidence: 99%

“…Initial animal studies demonstrated that using anesthetic to block nerve fibers before trauma prevents hyperexcitability in the dorsal horn of the spinal cord, which is believed to be an important mechanism of central sensitization [1]. Existing literature, however, has noted conflicting results when this theory is applied clinically to postoperative pain management [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Some authors have suggested that the effects of preemptive analgesia may vary according to the type of surgery [12].…”

Section: Introductionmentioning

confidence: 99%

Randomized trial of preemptive local analgesia in vaginal surgery

et al. 2008

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Preemptive analgesia in vaginal surgery has had conflicting efficacy reported in the existing literature. This study was designed to clarify the usefulness of preemptive local analgesia (PLA) in patients undergoing vaginal hysterectomy. A prospective, randomized, double-blinded trial of PLA in 90 women undergoing vaginal hysterectomy was conducted. PLA consisted of 20 ml of 0.5% bupivacaine with 1:200,000 epinephrine injected in a paracervical-type fashion. Total narcotic use and pain (using a visual analog scale (VAS)) was recorded at 30 min, 3, 12, and 24 h postoperatively. The mean total dose of narcotic was significantly less in the PLA group versus the placebo group (P = 0.009) at every time point postoperatively. Additionally, the mean pain VAS 30 min and 3 h postoperatively was 43% (P = 0.003) and 33% (P = 0.02) lower, respectively, in the PLA group. PLA with bupivacaine prior to vaginal hysterectomy is associated with significantly lower pain scores and a reduction in narcotic use postoperatively.

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“…However, studies related with abdominal hysterectomy demonstrated that local anesthetic wound infiltration does not decrease postoperative opioid requirements or improve patient comfort. 24,25 Local anesthetic wound infiltration may reduce post-thyroidectomy pain. Gozal et al 26 reported that bupivacaine infiltration in thyroid surgery markedly reduced opioid requirements.…”

Section: Discussionmentioning

confidence: 99%

Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption

Karamanlıoğlu

Turan

Memiş

et al. 2005

Can J Anesth/J Can Anesth

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Purpose:To compare efficacy and patient outcome of wound infiltration with ropivacaine, lornoxicam, or their combination for control of pain following thyroid surgery. Methods:Eighty patients underwent thyroid surgery were randomly assigned to one of four groups. Before skin closure, local tissues were infiltrated with 12 mL saline in Group S, with 10 mL of ropivacaine 0.75% plus 2 mL saline in Group R, with 2 mL of lornoxicam (8 mg) plus 10 mL saline in Group L, and with 10 mL ropivacaine 0.75% plus 2 mL lornoxicam (8 mg) in Group RL. Pain scores, total and incremental meperidine consumption were recorded at 30 min, one, two, three, four, six, eight, 12, 18, and 24 hr postoperatively. Time to first analgesic requirement, patient satisfaction, and duration of hospital stay were also compared after surgery. Results:The pain scores in Group RL were significantly lower in the first 12 hr than in Group S, and in the first four hours than in Groups R and L (P < 0.01). The time to first analgesic requirement was significantly longer (14.8 ± 8.4 hr vs 5.9 ± 5.2 hr; P < 0.01), the total pethidine consumption was significantly less than Group S (34.0 ± 33.0 mg vs 78.0 ± 29.8 mg; P<0.001), return of gastrointestinal function, ambulation time, length of hospital stay (P < 0.05) were significantly shorter, and patient satisfaction (P < 0.01) was significantly better in Group RL than in Group S (P < 0.05). Conclusion: Wound infiltration with ropivacaine 0.75% plus lornoxicam 8 mg combination improved postoperative pain control and patient comfort, and decreased the need for opioids than the use of either drug alone. (14,8 ± 8,4 h vs 5,9 ± 5,2 h ; P < 0,01), la consommation totale de péthidine a été plus basse que dans le groupe S (34,0 ± 33,0 mg vs 78,0 ± 29,8 mg ; P < 0,001) Objectif

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Infiltration of the abdominal wall with local anaesthetic after total abdominal hysterectomy has no opioid-sparing effect

Cited by 58 publications

References 1 publication

Intraperitoneal and intravenous lidocaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study

Intraperitoneal and intravenous lidocaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study

Randomized trial of preemptive local analgesia in vaginal surgery

Infiltration with ropivacaine plus lornoxicam reduces postoperative pain and opioid consumption

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