Intraperitoneal lignocaine for pain relief after total abdominal hysterectomy

Abstract

In this preliminary randomized study, we have measured pain scores at rest and on movement, 24 and 48 h after operation in 19 control patients, who received 50 ml of saline i.p., and in 20 test patients, in whom 50 ml of saline solution containing lignocaine 200 mg and adrenaline 1:500,000 were instilled into the peritoneal cavity after total abdominal hysterectomy. We found that there was no difference in linear analogue scores for nausea, pain on movement or morphine consumption after operation between the two groups, but pain scores at rest were significantly lower in the lignocaine group at 24 and 48 h compared with the saline group. In the lignocaine group, blood sampling over a 3-h period revealed a mean maximum serum concentration of 0.4 microgram ml-1 at 3 h and a highest concentration in any patient of 0.87 microgram ml-1.

Assessment of postoperative analgesia after intraperitoneal instillation of lornoxicam in laparoscopic appendectomy: a randomized study

“…Bupivacaine, levobupivacaine, lidocaine and ropivacaine have been used intraperitoneally in varying doses to achieve analgesia in various laparoscopic surgeries. [9][10][11][12] In the studies, after the laparoscopic surgeries, the intraperitoneal local anesthetics are found to be very effective for the decrease in postoperative pain. 13 This non-invasive method has a minimum risk and it can be easily applied.…”

Presumptive intraperitoneal envenomation resulting in hemoperitoneum and acute abdominal pain in a dog

“…Campagnol found that a single IP injection of bupivacaine (5 mg/kg) resulted in lower pain scores for 1 hour after ovariohysterectomy in dogs. Others have demonstrated that human patients undergoing various laparoscopic or surgical procedures such as cholecystectomy, gynecological procedures, gastric bypass, or banding have an overall reduction in abdominal pain and postoperative opioid use when given IP injections of local anesthetics . Although others have reported no benefit of IP local anesthetic administration, there are no reports of significant complications of injection.…”

“…A single prospective, randomized, double‐blind trial evaluated the effect of continuous IP local anesthetic infusion on postoperative pain following laparoscopic surgery in adults . Although sample size was small, the authors found that continuous IP infusion of bupivacaine, compared to a saline placebo, resulted in reduced pain from 6 to 48 hours postoperatively when combined with traditional parenteral morphine administration.…”

Disposition and Clinical Outcome After Intraperitoneal Meperidine and Ropivacaine Administration During Laparoscopic Surgery

“…21 However, our clinical findings support a lack of analgesic efficacy after laparoscopic cholecystectomy 9,22,23 or after major gynecologic surgery. [2][3][4] Of note, one of the few studies to report efficacy provided a prolonged IP infusion via a catheter 8 and there is some evidence that high concentrations administered before dissection are more effective. 10 Although small doses of IP morphine are not effective after laparoscopic sterilization, 24 Colbert et al 11 reported improved analgesia when meperidine 50 mg was added to IP bupivacaine 100 mg and epinephrine, rather than injected IM.…”

“…1 Evidence for the effectiveness of IP LA is less compelling when used for more extensive intraabdominal and pelvic laparoscopic surgery. Trials involving major gynecologic surgery have been disappointing, mostly showing no benefit [2][3][4] or, at best, a short-term and modest effect. [5][6][7] Only one trial reported a significant reduction in morphine consumption and also less postoperative nausea and vomiting (PONV).…”