Intraperitoneal local anaesthetic in abdominal surgery – a systematic review

Kahokehr, Arman; Sammour, Tarik; Soop, Mattias; Hill, Andrew G.

doi:10.1111/j.1445-2197.2010.05573.x

Cited by 69 publications

(41 citation statements)

References 60 publications

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“…The route of administration of local anesthetic varies, with the subcutaneous and intraperitoneal routes being most frequently used [7,9,10]. However, there is wide heterogeneity in clinical practice, with no strong evidence in favor of either route of administration [11]. In addition, to our knowledge, there have been no studies to assess use of local anesthetic administration in laparoscopic colorectal procedures, with all data referring to laparoscopic general surgery and gynecological procedures.…”

Section: Introductionmentioning

confidence: 97%

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

et al. 2011

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Section: Introductionmentioning

confidence: 97%

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

et al. 2011

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“…It provides adequate analgesia without any side effect unlike intravenous opioids. Intraperitoneal (IP) instillation of local anesthetic agents alone [7] or in combination with opioids [8,9] and α-2 agonists such as clonidine [10] and dexmedetomidine [11] has been found to reduce post-operative pain following laparoscopic gynecological surgeries. This prospective controlled study was conducted to compare the analgesic efficacy of IP ropivacaine with or without dexmedetomidine for postoperative analgesia after total laparoscopic hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Analgesia With Intraperitoneal Ropivacaine With and Without Dexmedetomidine After Total Laparoscopic Hysterectomy: A Randomized, Double-Blind, Controlled Trial

Acharya

Karan²,

Khetan³

2016

Asian J Pharm Clin Res

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Objective: In this advanced era of surgery, laparoscopic hysterectomy operations are very commonly practiced by surgeons. It reduces trauma, morbidity, and health-care costs, ensuring early discharge. However, the early post-operative pain experienced by patients may sometimes negate all the advantages of a laparoscopic procedure. Intraperitoneal (IP) instillation of local anesthetics has been proposed to decrease post-operative pain after laparoscopic surgeries. Additives to local anesthetics like α-2 agonists such as clonidine and dexmedetomidine prolong the duration of analgesia. Therefore, this randomized, prospective, controlled study was conducted to compare the analgesic efficacy of IP ropivacaine with or without dexmedetomidine for postoperative analgesia after total laparoscopy hysterectomy. Methods:At the end of laparoscopic hysterectomy, in a double-blind, randomized manner, one of the following injections was given intraperitoneally. The patients were allocated into the following two groups: The patients in ropivacaine group (R group) (N = 40) were given 38 ml of 0.2% ropivacaine plus 2 ml of normal saline (NS) and the patients in ropivacaine plus dexmedetomidine group (RD group) (N = 40) were given 38 ml of 0.2% ropivacaine combined with 0.5 µg/kg dexmedetomidine (diluted in 2 ml NS) through trocars. All the patients were given diclofenac sodium when they had a pain score of 4 on visual analog scale (VAS).Results: VAS score at different time intervals was significantly lower after the second postoperative hour, time to first request of analgesia (minutes) was longest (487.7±40.96 vs. 242.5±19.84), and the total analgesic consumption (mg) was lowest (61.88±37.55 vs. 183.75±44.78) in RD group than in R group. Conclusion:The antinociceptive effects of the IP instillation of ropivacaine in combination with dexmedetomidine are superior to ropivacaine alone in laparoscopic hysterectomy cases.

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“…For these reasons, concerted efforts have been made to study and apply various combined approaches aimed at reducing post-operative pain. These approaches have included standard opioid and non-opioid analgesics (NSAIDs) [10], epidural anesthesia/analgesia [11,12], the use of short-term operative site drains [13], intra-peritoneal irrigation with saline [14][15][16] or local anesthetic [10,11,15,[24][25][26], administration of systemic corticosteroid [27], or opioid analgesics [28].…”

Section: Discussionmentioning

confidence: 99%

Prospective randomized controlled trial comparing standard analgesia with combined intra-operative cystic plate and port-site local anesthesia for post-operative pain management in elective laparoscopic cholecystectomy

et al. 2016

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Intraperitoneal local anaesthetic in abdominal surgery – a systematic review

Abstract: The use of IPLA is safe and appears to have clinical benefits. However this technique has not been studied in optimized perioperative settings. Trials are needed to evaluate this method of visceral blockade further after major abdominal surgery.

Cited by 69 publications

References 60 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

Postoperative Analgesia With Intraperitoneal Ropivacaine With and Without Dexmedetomidine After Total Laparoscopic Hysterectomy: A Randomized, Double-Blind, Controlled Trial

Prospective randomized controlled trial comparing standard analgesia with combined intra-operative cystic plate and port-site local anesthesia for post-operative pain management in elective laparoscopic cholecystectomy

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