Is intraperitoneal levobupivacaine with epinephrine useful for analgesia following laparoscopic cholecystectomy? A randomized controlled trial

Ng, Alexander; Swami, A.; Smith, G.; Robertson, Gavin S.; Lloyd, David M.

doi:10.1017/s0265021504008117

Cited by 16 publications

(7 citation statements)

References 23 publications

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“…13 In an effort to reduce the post-LC-related pain, several randomized clinical trials examined various analgesic modalities including NSAIDS, opioid, wound infiltration, and intraperitoneal analgesia with local anesthetics. 4,14,15 Unfortunately the outcome is inconclusive. Lee et al 16 failed to demonstrate effective treatment of shoulder tip pain with both incisional and intraabdominal local anesthetic treatment.…”

Section: Discussionmentioning

confidence: 99%

Shoulder Tip Pain After Laparoscopic Surgery Analgesia by Collateral Meridian Acupressure (Shiatsu) Therapy: A Report of 2 Cases

Yeh

Ko²,

Huh

et al. 2008

Journal of Manipulative and Physiological Therapeutics

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Section: Discussionmentioning

confidence: 99%

Shoulder Tip Pain After Laparoscopic Surgery Analgesia by Collateral Meridian Acupressure (Shiatsu) Therapy: A Report of 2 Cases

Yeh

Ko²,

Huh

et al. 2008

Journal of Manipulative and Physiological Therapeutics

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“…The reported incidence of PLSP was 63% after laparoscopic cholecystectomy 6, 66% after laparoscopic adjustable gastric band surgery 7, 65.5% after laparoscopic appendectomy 8 and 83% after gynecological laparoscopic surgeries 5. For improving the postoperative quality of life (QOL) for these patients, various techniques, including low-pressure insufflation, no CO 2 insufflation, preemptive diaphragmatic local anesthetic irrigation and regional anesthesia to peritoneal surfaces, have been developed to reduce the PLSP 9-13. Unfortunately, the effectiveness of these techniques was quite varied and even conflicting 7.…”

Section: Introductionmentioning

confidence: 99%

Multiple-, But Not Single-, Dose of Parecoxib Reduces Shoulder Pain after Gynecologic Laparoscopy

Zhang¹,

Shu²,

Lei³

et al. 2012

Int. J. Med. Sci.

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Background: The aim of this study was to investigate effect of single- and multiple-dose of parecoxib on shoulder pain after gynecologic laparoscopy.Methods: 126 patients requiring elective gynecologic laparoscopy were randomly allocated to three groups. Group M (multiple-dose): receiving parecoxib 40mg at 30min before the end of surgery, at 8 and 20hr after surgery, respectively; Group S (single-dose): receiving parecoxib 40mg at 30min before the end of surgery and normal saline at the corresponding time points; Group C (control): receiving normal saline at the same three time points. The shoulder pain was evaluated, both at rest and with motion, at postoperative 6, 24 and 48hr. The impact of shoulder pain on patients' recovery (activity, mood, walking and sleep) was also evaluated. Meanwhile, rescue analgesics and complications were recorded.Results: The overall incidence of shoulder pain in group M (37.5%) was lower than that in group C (61.9%) (difference=-24.4%; 95% CI: 3.4~45.4%; P=0.023). Whereas, single-dose regimen (61.0%) showed no significant reduction (difference with control=-0.9%; 95% CI: -21.9~20.0%; P=0.931). Moreover, multiple-dose regimen reduced the maximal intensity of shoulder pain and the impact for activity and mood in comparison to the control. Multiple-dose of parecoxib decreased the consumption of rescue analgesics. The complications were similar among all groups and no severe complications were observed.Conclusions: Multiple-, but not single-, dose of parecoxib may attenuate the incidence and intensity of shoulder pain and thereby improve patients' quality of recovery following gynecologic laparoscopy.

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“…[1] Pain after laparoscopic cholecystectomy is affect by several factors including patient demographics, nature of underlying disease, surgical factors, volume of residual gas, type of gas used for pneumoperitoneum, and the pressure created by the pneumoperitoneum. [13–18] A number of techniques have been described for reducing postlaparoscopy pain including: Preincisional infiltration and intraperitoneal instillation of levobupivacaine 0.25%;[19] intraperitoneal ropivacaine and a gas drain;[20] intraperitoneal levobupivacaine with epinephrine;[21] intraperitoneal application of bupivacaine plus morphine;[22] preincisional injection of bupivacaine;[23] pre-emptive intraperitoneal injection of ropivacaine;[24] and intraperitoneal lidocaine combined with intravenous or intraperitoneal tenoxicam. [25] It is suggested that post-laparoscopic cholecystectomy pain is multifactorial and methods for short term analgesia cannot improve postoperative functions or shortened hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal hydrocortisone for pain relief after laparoscopic cholecystectomy

et al. 2013

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Background:Laparoscopic cholecystectomy is associated with shorter hospital stay and less pain in comparison to open surgery. The aim of this study was to evaluate the effect of intraperitoneal hydrocortisone on pain relief following laparoscopic cholecystectomy.Methods:Sixty two patients were enrolled in a double-blind, randomized clinical trial. Patients randomly received intraperitoneal instillation of either 250 ml normal saline (n=31) or 100 mg hydrocortisone in 250 ml normal saline (n=31) before insufflation of CO2 into the peritoneum. Abdominal and shoulder pain were evaluated using VAS after surgery and at 6, 12, and 24 hours postoperatively. The patients were also followed for postoperative analgesic requirements, nausea and vomiting, and return of bowel function.Results:Sixty patients completed the study. Patients in the hydrocortisone group had significantly lower abdominal and shoulder pain scores (10.95 vs 12.95; P<0.01). The patients were similar regarding analgesic requirements in the recovery room. However, those in the hydrocortisone group required less meperidine than the saline group (151.66 (±49.9) mg vs 61.66 (±38.69) mg; P=0.00). The patients were similar with respect to return of bowel function, nausea and vomiting. No adverse reaction was observed in either group.Conclusion:Intraperitoneal administration of hydrocortisone can significantly decrease pain and analgesic requirements after laparoscopic cholecystectomy with no adverse effects.

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Is intraperitoneal levobupivacaine with epinephrine useful for analgesia following laparoscopic cholecystectomy? A randomized controlled trial

Abstract: Intraperitoneal administration of levobupivacaine with epinephrine is associated with modest analgesia following laparoscopic cholecystectomy.

Cited by 16 publications

References 23 publications

Shoulder Tip Pain After Laparoscopic Surgery Analgesia by Collateral Meridian Acupressure (Shiatsu) Therapy: A Report of 2 Cases

Shoulder Tip Pain After Laparoscopic Surgery Analgesia by Collateral Meridian Acupressure (Shiatsu) Therapy: A Report of 2 Cases

Multiple-, But Not Single-, Dose of Parecoxib Reduces Shoulder Pain after Gynecologic Laparoscopy

Intraperitoneal hydrocortisone for pain relief after laparoscopic cholecystectomy

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