Intraperitoneal Ropivacaine Instillation for Postoperative Pain Relief after Laparoscopic Cholecystectomy

Kim, Tae Han; Kang, Hyun; Park, Jun Seok; Chang, In Taik; Park, Sun Gyoo

doi:10.4174/jkss.2010.79.2.130

Cited by 44 publications

(43 citation statements)

References 23 publications

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“…20 A large number of studies have examined the intraperitoneal administration of local anaesthetics in laparoscopic cholecystectomies with regard to postoperative pain and narcotic analgesic consumption with promising results. 10,[21][22][23] However, there are other studies also which show that the post-operative analgesia and narcotic usage was not significantly different in the groups that received local anaesthesia. [24][25][26] The timing of the administration of the local anaesthetic during surgery has also been debated.…”

Section: Discussionmentioning

confidence: 99%

Comparison of intraincisional vs intraperitoneal bupivacaine for the control of postoperative pain after laparoscopic cholecystectomy

Bacha¹,

Mushtaque²,

Tahir³

2019

Int Surg J

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The main reason for using multimodal analgesia techniques is to avoid possible side effects by limiting the utilisation of commonly used opioids to provide postoperative analgesia. 9 So far many studies have been done using intraperitoneal or intraincisional local anaesthetic infiltration, but the results have been conflicting. [10][11][12][13][14] The aim of our study was to compare the ABSTRACT Background: The aim of this study was to compare the efficacy of infiltration of local anaesthetic bupivacaine at incision site (port site) and intraperitoneally on postoperative pain in patients undergoing laparoscopic cholecystectomy. Methods: This was a randomized controlled study carried out on patients undergoing laparoscopic cholecystectomy. The patients were divided into three groups of 60 patients each. Group 1 was the control group which did not receive either intraincisional or intraperitoneal bupivacaine. Group 2 received intraincisional bupivacaine 0.25% 20 ml, while group 3 received 20 ml solution of bupivacaine 0.25% 20 ml intraperitoneally. Postoperative pain was recorded for 24 hours post-operatively. Results: The incidence of abdominal pain was significantly lower in the group which received intraincisional bupivacaine upto 12 hours postoperatively. Right shoulder pain was low in group receiving intraperitoneal bupivacaine as compared to group 2, but it was not statistically significant. Conclusions: Intraincisional (port site) infiltration of bupivacaine is more effective than intraperitoneal infiltration for postoperative pain relief after laparoscopic cholecystectomy. It is easier to apply and there is less requirement of postoperative analgesics.

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Section: Discussionmentioning

confidence: 99%

Comparison of intraincisional vs intraperitoneal bupivacaine for the control of postoperative pain after laparoscopic cholecystectomy

Bacha¹,

Mushtaque²,

Tahir³

2019

Int Surg J

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“…Previous studies prove that though laparoscopy is a minimally invasive procedure, certain degree of pain is still experienced by patients. Pain can be multifactorial arising from incision site (somatic pain), from surgical site (visceral pain), and due to pneumoperitoneum (referred pain) [12]. Out of the different regimens proposed for post-operative pain such as intravenous NSAIDS, opioids, and local infiltration, IP infiltration of local anesthetic has been chosen by many surgeons as an effective modality.…”

Section: Discussionmentioning

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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“…[8142127] However, other studies indicate that the post-operative analgesia and narcotic usage was not significantly different in the groups that received local anaesthesia. [252829]…”

Section: Discussionmentioning

confidence: 99%

Intraincisional vs intraperitoneal infiltration of local anaesthetic for controlling early post-laparoscopic cholecystectomy pain

et al. 2011

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BACKGROUND:The study was designed to compare the effect of intraincisional vs intraperitoneal infiltration of levobupivacaine 0.25% on post-operative pain in laparoscopic cholecystectomy.MATERIALS AND METHODS:This randomised controlled study was carried out on 189 patients who underwent laparoscopic cholecystectomy. Group 1 was the control group and did not receive either intraperitoneal or intraincisional levobupivacaine. Group 2 was assigned to receive local infiltration (intraincisional) of 20 ml solution of levobupivacaine 0.25%, while Group 3 received 20 ml solution of levobupivacaine 0.25% intraperitoneally. Post-operative pain was recorded for 24 hours post-operatively.RESULTS:Post-operative abdominal pain was significantly lower with intraincisional infiltration of levobupivacaine 0.25% in group 2. This difference was reported from 30 minutes till 24 hours post-operatively. Right shoulder pain showed significantly lower incidence in group 2 and group 3 compared to control group. Although statistically insignificant, shoulder pain was less in group 3 than group 2.CONCLUSION:Intraincisional infiltration of levobupivacaine is more effective than intraperitoneal route in controlling post-operative abdominal pain. It decreases the need for rescue analgesia.

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Intraperitoneal Ropivacaine Instillation for Postoperative Pain Relief after Laparoscopic Cholecystectomy

Cited by 44 publications

References 23 publications

Comparison of intraincisional vs intraperitoneal bupivacaine for the control of postoperative pain after laparoscopic cholecystectomy

Comparison of intraincisional vs intraperitoneal bupivacaine for the control of postoperative pain after laparoscopic cholecystectomy

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

Intraincisional vs intraperitoneal infiltration of local anaesthetic for controlling early post-laparoscopic cholecystectomy pain

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