Intraperitoneal bupivacaine for the reduction of postoperative pain following operative laparoscopy: a pilot study and review of the literature

Buck, Lucie; Varras, M; Miskry, Tariq; Ruston, John; Magos, Adam

doi:10.1080/01443610410001685637

Cited by 17 publications

(10 citation statements)

References 9 publications

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“…The data reported in our study do not match the results of several randomized controlled trials which assessed use of intraperitoneal local anesthetic administration in the setting of simpler laparoscopic procedures, such as laparoscopic cholecystectomy, inguinal hernia repair, and fundoplication [9,10,19]. In this context, the extent of surgical trauma, the timing and type of local anesthetic administered, as well as the route of administration are likely to play an important role.…”

Section: Discussioncontrasting

confidence: 81%

Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery

et al. 2011

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Section: Discussioncontrasting

confidence: 81%

Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery

et al. 2011

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“…A study of Buck L, Verras MN, Miskry T, Ruston J and Magos A, 12 on intraperitoneal bupivacaine for the reduction of postoperative pain following operative laparoscopy. This pilot case-control study was carried out to determine the value of intraperitoneal irrigation with a long-acting local anaesthetic agent in reducing postoperative analgesic requirements following gynaecological operative laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

To Study the Analgesic Effect of Instillation of 20 Ml 0.5% Bupivacaine Intraperitoneal Route at the End of Laparoscopic Surgery With Control 20 Ml 0.9% Saline Intraperitoneally

Inugala¹,

Murali²

2016

jemds

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Laparoscopy involves insufflation of the abdomen by gas, so that the endoscope (usually 6-10 mm in diameter) can view the intra-abdominal contents without being in direct contact with the viscera or tissues. Surgical procedures can be carried out by instruments produced through one or more additional ports. In a systematic review, we evaluated Randomized Controlled Trials (RCTs) of Local Anaesthetics (LA) compared with placebo or no treatment in the control of postoperative pain after laparoscopic surgery. A total of 41 trials with data from 2794 patients were considered appropriate for analysis. Of these 41 RCTs, 13 evaluated intraperitoneal LA after cholecystectomy, four RCTs assessed intraperitoneal LA after other procedures, eight RCTs evaluated portsite infiltration after various procedures, 12 RCTs evaluated mesosalpinx or fallopian tube block after sterilization, and four RCTs considered combined LA regimens. MATERIALS AND METHODSThis study was conducted in 80 patients aged 30-50 years. The patients were divided into two Groups A -Saline, B -0.5 Bupivacaine intraperitoneal instillation; 40 patients in each group undergoing elective and emergency surgery. OBSERVATIONS AND RESULTSThis study was undertaken to compare the post-operative analgesic effect of 20 mL 0.5% Bupivacaine given intraperitoneally at the end of laparoscopic surgery with control 0.9% saline 20 mL at MGM Hospital, C.K.M. Hospital, Kakatiya Medical College, Warangal, during the period from January 2009 to July 2009. Bupivacaine group had better postoperative pain relief in the first six hours with no complications. CONCLUSION0.5% Bupivacaine intraperitoneal instillation is effective for abdominal surgeries, especially hysterectomy, appendicectomy and cholecystectomy. KEYWORDSAnaesthesia, Bupivacaine, Intraperitoneal, Saline, Glycopyrrolate, Fentanyl, Lidocaine, Propofol, VAS (Visual Analog Scale). HOW TO CITE THIS ARTICLE:Inugala RR, Murali CH. To study the analgesic effect of instillation of 20 mL 0.5% bupivacaine intraperitoneal route at the end of laparoscopic surgery with control 20 mL 0.9% saline intraperitoneally. 14-07-2016, Peer Review 10-08-2016, Acceptance 16-08-2016, Published 24-08-2016. Corresponding Author: Dr. Rajkumar Reddy Inugala, H. No.: 1-7-1323, Advocates Colony, Balasamudram, Hanamkonda, Warangal -Dist., Telangana State. E-mail: rajkumaringala@gmail.com DOI: 10.14260/jemds/2016/1111 Laparoscopy involves insufflations of the abdomen by gas, so that the endoscope (usually 6-10 mm in diameter) can view the intra-abdominal contents without being in direct contact with the viscera or tissues. Surgical procedures can be carried out by instruments produced through one or more additional ports. Laparoscopy therefore refines the surgical approach and is associated with pain, which is additional to that caused by intra-abdominal trauma. Nevertheless, pain which occurs after this procedure is significantly less and shorter than that caused by the same surgical procedure made possible by laparotomy.Surgical proce...

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“…1,2 This technique reduces early postoperative analgesic requirements, pain scores, and time to firstintervention analgesia after abdominal surgery in humans. [3][4][5][6][7][8][9][10][11][12] According to meta-analyses and systematic reviews, IP administration of bupivacaine currently is recommended for laparoscopic surgery in humans as an adjuvant analgesic technique. 3,[13][14][15][16] Intraperitoneal administration of bupivacaine can reduce pain scores and blunt surgery-induced stress responses in dogs undergoing ovariohysterectomy.…”

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confidence: 99%

Pharmacokinetics of bupivacaine after intraperitoneal administration to cats undergoing ovariohysterectomy

Benito¹,

Monteiro²,

Beaudry³

et al. 2016

ajvr

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OBJECTIVE To evaluate pharmacokinetics of bupivacaine after IP administration to cats undergoing ovariohysterectomy. ANIMALS 8 healthy cats. PROCEDURES Anesthesia was induced with propofol and maintained with isoflurane. Buprenorphine (0.02 mg/kg, IV) and meloxicam (0.2 mg/kg, SC) were administered. A 20-gauge catheter was inserted into a jugular vein for blood sample collection. A ventral midline incision was made, and a solution of 0.5% bupivacaine (2 mg/kg) diluted with an equal volume of saline (0.9% NaCl) solution (final concentration, 0.25% bupivacaine) was injected into the peritoneal space over the right and left ovarian pedicles and caudal aspect of the uterus before ovariohysterectomy. Cats were monitored for signs of bupivacaine toxicosis. Venous blood samples (2 mL) were collected before (time 0) and 2, 5, 10, 15, 20, 30, 60, 120, and 240 minutes after bupivacaine administration. Plasma bupivacaine concentrations were determined with a liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters were determined by data plotting followed by analysis with a noncompartmental model. RESULTS No signs of bupivacaine toxicosis were observed. Maximum bupivacaine plasma concentration was 1,030 ± 497.5 ng/mL at a mean ± SD value of 30 ± 24 minutes after administration. Mean elimination half-life was 4.79 ± 2.7 hours. Mean clearance indexed by bioavailability and volume of distribution indexed by bioavailability were 0.35 ± 0.18 L•h/kg and 2.10 ± 0.84 L/kg, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Intraperitoneal administration of bupivacaine resulted in concentrations that did not cause observable toxicosis. Studies to investigate analgesic effects for this technique in cats are warranted.

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Intraperitoneal bupivacaine for the reduction of postoperative pain following operative laparoscopy: a pilot study and review of the literature

Cited by 17 publications

References 9 publications

Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery

Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery

To Study the Analgesic Effect of Instillation of 20 Ml 0.5% Bupivacaine Intraperitoneal Route at the End of Laparoscopic Surgery With Control 20 Ml 0.9% Saline Intraperitoneally

Pharmacokinetics of bupivacaine after intraperitoneal administration to cats undergoing ovariohysterectomy

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