Intraperitoneal instillation of ropivacaine plus dexmedetomidine for pain relief after laparoscopic hysterectomy: A comparison with ropivacaine alone

Chiruvella, Sunil; Nallam, Srinivasa Rao

doi:10.4103/2277-8632.185432

Cited by 10 publications

(16 citation statements)

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“…VAS scores at different time intervals were statistically significantly lower at all times in group A compared to group B (Table 2). There were statistically significant differences in VAS scores between group A and group B at all postoperative time points -1 hr, 4 24 hr (p < 0.00001).VAS scores in group А were significantly lower (Table 2 and Figure 1).…”

Section: Resultsmentioning

confidence: 88%

“…[16] Another study evaluated intraperitoneal instillation of 30 ml 0.2% ropivacaine (R group) versus intraperitoneal instillation of 30 ml 0.2% ropivacaine combined with 1 μgr/ kg dexmedetomidine (RD group) and they reported significantly reduced VAS scores in 24 hrs postoperatively, time to first request of analgesia was longest and total analgesic consumption was lowest in RD group compared to R group. [4] CONCLUSION Intraperitoneal instillation of bupivacaine provides good analgesia in the postoperative period after laparoscopic cholecystectomy. Our study showed this technique to be an effective alternative method for early pain control and to minimize the need of opioid analgesics in the postoperative period.…”

Section: Discussionmentioning

confidence: 94%

“…Shoulder pain, which is associated with peritoneal insufflations, occurs especially when shoulder holders and an exaggerated Trendelenburg position are used that frequently complicate the postoperative period after the laparoscopic surgery. [4] Pain on the day of surgery is typically a diffuse abdominal pain, and more so to the right upper quadrant and right shoulder tip. [2] Many methods have been proposed to improve pain control such as the use of local anesthetics at the troacar site, intraperitoneal injection of local anesthetics, intermittent intravenous non-steroidal anti-inflammatory drugs (NSAIDs), intermittent intramuscular narcotics, decreasing pneumoperitoneum pressure, and decreasing the number of operative ports.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Intraperitoneal Bupivacaine on Pain Relief After Laparoscopic Cholecystectomy

Toleska

Карталов

Кузмановска

et al. 2018

Prilozi

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Introduction: Patients undergoing laparoscopic cholecystectomy do experience postoperative pain, especially in the abdomen. Postoperative pain management remains a major challenge after laparoscopic procedures. Administration of intraperitoneal local anesthetic (IPLA) after surgery is used as a method of reducing postoperative pain. In this study, we evaluated the effect of intraperitoneal infiltration of local anesthetic (bupivacaine) for pain relief after laparoscopic cholecystectomy. Material and methods: In this prospective, controlled, and randomized study were included 50 patients aged 25-60 years (35 female and 15 male), scheduled to laparoscopic cholecystectomy with ASA classification 1 and 2. Patients were classified randomly into two groups: group A, which included 25 patients who received intraperitoneal instillation of bupivacaine 0.5% 20 ml; and group B, which included 25 patients who didn’t receive any intraperitoneal instillation. Postoperative pain was recorded using the visual analogue scale (VAS) for 24 hours after laparoscopic cholecystectomy. Results: There was no significant difference with respect to age, weight, and sex; duration of surgery; and anesthesia time. VAS scores at different time intervals were statistically significantly lower at all times in group A compared to group B. There were statistically significant differences in VAS scores between group A and group B at all postoperative time points - 1hr,4 hr,8 hr,12hr and 24hr (p < 0.00001). Conclusion: Intraperitoneal instillation of bupivacaine provides good analgesia in the postoperative period after laparoscopic cholecystectomy.

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Section: Resultsmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of Intraperitoneal Bupivacaine on Pain Relief After Laparoscopic Cholecystectomy

Toleska

Карталов

Кузмановска

et al. 2018

Prilozi

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“…Ñüîãîäí³ äëÿ ë³êóâàííÿ ÏÁÑ âèêîðèñòîâóºòüñÿ ñòðàòåã³ÿ ìóëüòèìîäàëüíîãî çíåáîëåííÿ, ÿêà âêëþ-÷àº â ñåáå âèêîðèñòàííÿ ïðîòèáîëüîâèõ ïðåïàðàò³â ç ð³çíèìè ìåõàí³çìàìè ä³¿. Îñòàíí³ì ÷àñîì â ÿêîñò³ êîìïîíåíòà òàêîãî çíåáîëåííÿ ïðè ïðîâåäåíí³ ìà-ëî³íâàçèâíèõ âòðó÷àíü ïî÷àëè âèêîðèñòîâóâàòè âíóòð³øíüî÷åðåâíå ââåäåííÿ òà ³íô³ëüòðàö³þ ì³ñöü ïðîâåäåííÿ òðîàêàð³â ì³ñöåâèìè àíåñòåòèêàìè [2,8]. Öåé ìåòîä áóâ âïåðøå çàñòîñîâàíèé ùå ó 1951 ðîö³ [10], àëå ï³çí³øå áóâ íåñïðàâåäëèâî çàáóòèé ïðîòÿãîì ê³ëüêîõ äåñÿòèð³÷.…”

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“…Ó äîñë³äaeåíí³ [8] âíóòð³øíüî÷åðåâíà ³íñòèëÿ-ö³ÿ áóï³âîêà¿íó 0,5% 20 ìë çíà÷íî çìåíøóâàëà ï³ñëÿîïåðàö³éíèé á³ëü ï³ñëÿ ìàëèõ ã³íåêîëîã³÷íèõ îïåðàö³é. Â ï³ñëÿîïåðàö³éíîìó ïåð³îä³ aeîäíà ç ïàö-³ºíòîê íå ñêàðaeèëàñÿ íà òàê³ ïîá³÷í³ åôåêòè ì³ñöåâèõ àíåñòåòèê³â, ÿê ñâåðá³ae, ñåäàòèâíèé åôåêò, áðà-äèêàðä³þ, ã³ïîòîí³þ òà òðåìò³ííÿ.…”

mentioning

confidence: 99%

Intraperitoneal Using of Bupivаcain for the Anesthesia of Patients After Laparoscopic Cholecystectomy

et al. 2018

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Relevance. The local anesthetics were used intraperitoneally after some minimally invasive gynecological interventions like a component of postoperative multimodal anesthesia in recent years. Objective. The aim of work was to study the effectiveness of intraperitoneal administration of bupivokain for the anesthesia of patients after laparoscopic cholecystectomy. Material and methods. 28 patients aged 32-60 years (16 women, 12 men) were examined. The patients were divided into two groups. In the first group for anesthesia after the operation, was used ketorolac trometamine in dose 0.2 mg/kg intramuscularly each 6 hours. If the patient complained of postoperative pain, which was assessed by Visual-analog scale in 7 points or higher, fentanyl was administered intramuscularly in dose of 0.003 μg/kg. In the second group, besides the components of multimodal anesthesia used in the first group, at the end of the surgical intervention at the drainage tubes were injected 40 ml of 0.125% solution of bupivocaine (50 mg). This injection was repeated throughout the first day each 6 hours. The condition of patients was assessed by a Visual-analog scale after 1, 4, 8, 12 and 24 hours after the finishing of surgery. The average dose of fentanyl in μg/kg used for postoperative anesthesia first 24 hours after operation was also determined. Results. We have received a significant reduction in the rates of pain evaluation for Visual-analog scale in patients who used bupivacaine as a component of multimodal anesthesia. One hour after the end of the operation, the pain score for Visual-analog scale was less than the corresponding one in the control group in 1.77 times, after 4 hours – in 1.47, and in 8 hours – in 1.55 times. In all cases, P <0.001. The mean dose of fentanyl used for treatment in the study group was 1.55 times less than that in the control group. There were no significant complications in both groups. A patient in group 1 had nausea, requiring a single dose of ondasetron 2 mg Conclusion. Intraperitoneal administration of bupivocaine had a significant anesthetic effect after laparoscopic cholecystectomy.

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Randomized control trial of intra-peritoneal instillation of bupivacaine versus placebo for post-operative analgesia after laparoscopic hysterectomy

Dudam

Barsode

Borse

et al. 2022

Int J Reprod Contracept Obstet Gynecol

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Background: Laparoscopy is an established method to perform major surgeries, with many advantages over open surgeries. Hysterectomy is a common procedure performed with increased use of laparoscopy, having postoperative pain management is a major issue. Effective pain management promotes early ambulation, lowering the risk of DVT and PE.Methods: The present study aimed to assess effect of bupivacaine intraperitoneally during laparoscopic hysterectomy to reduce postoperative pain. 48 women undergoing laparoscopic hysterectomy under ASA I and II general anesthesia were included, divided into 2 groups, group A receiving 0.25% bupivacaine intraperitoneally; group B receiving saline. A blind observer observed both groups for 6 hours post-surgery or until the VAS was 4, whichever came first, need for rescue analgesia, side-effects, and total dose of analgesia required in 24 hours. Diclofenac sodium and paracetamol was used as rescue analgesia for both groups.Results: There was no significant difference reported in demographic parameters between two study groups. The VAS scores at 6, 12 and 24 hours after laparoscopy was significantly lower in group A than group B. There was significant increase in the time required for 1st analgesia, while amount of analgesia required was significantly low in group A as compared to group B. There were significantly more number of patients in group B who needed opioids than group A.Conclusions: Peritoneal bupivacaine instillation after laparoscopic hysterectomy was found to be useful to reduce the pain as compared to use of saline (placebo), significant reduction in need for analgesics in the postoperative period.

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Intraperitoneal instillation of ropivacaine plus dexmedetomidine for pain relief after laparoscopic hysterectomy: A comparison with ropivacaine alone

Cited by 10 publications

References 1 publication

Efficacy of Intraperitoneal Bupivacaine on Pain Relief After Laparoscopic Cholecystectomy

Efficacy of Intraperitoneal Bupivacaine on Pain Relief After Laparoscopic Cholecystectomy

Intraperitoneal Using of Bupivаcain for the Anesthesia of Patients After Laparoscopic Cholecystectomy

Randomized control trial of intra-peritoneal instillation of bupivacaine versus placebo for post-operative analgesia after laparoscopic hysterectomy

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