Local anesthesia with ropivacaine for patients undergoing laparoscopic cholecystectomy

Abstract

AIM:To investigate the effect of pain relief after infusion of ropivacaine at port sites at the end of surgery. METHODS:From October 2006 to September 2007, 72 patients undergoing laparoscopic cholecystectomy (LC) were randomized into two groups of 36 patients. One group received ropivacaine infusion at the port sites at the end of LC and the other received normal saline. A visual analog scale was used to assess postoperative pain when the patient awakened in the operating room, 6 and 24 h after surgery, and before discharge. The amount of analgesics use was also recorded. The demographics, laboratory data, hospital stay, and perioperative complications were compared between the two groups. RESULTS:There was no difference between the two groups preoperatively in terms of demographic and laboratory data. After surgery, similar operation time, blood loss, and no postoperative morbidity and mortality were observed in the two groups. However, a significantly lower pain score was observed in the patients undergoing LC with local anesthesia infusion at 1 h after LC and at discharge. Regarding analgesic use, the amount of meperidine used 1 h after LC and the total used during admission were lower in patients undergoing LC with local anesthesia infusion. This group also had a shorter hospital stay. CONCLUSION:Local anesthesia with ropivacaine at the port site in LC patients significantly decreased postoperative pain immediately. This explains the lower meperidine use and earlier discharge for these patients.

A comparative study of the incidence of pain and infection in gall bladder extraction via umbilical and epigastric port

“…4 Pain is the most frequent complaint after laparoscopic cholecystectomy and the main reason for staying overnight at hospital on the day of operation. 5 Pain after laparoscopic cholecystectomy depends on multiple factors including rupture of blood vessels caused by rapid distension of the peritoneum, traumatic traction on the nerves, trauma to the abdominal wall during port insertion and GB retrieval and pneumoperitoneum created by use of CO2 to maintain high abdominal pressure. 5 It is reported that incisional pain is more intense than visceral pain and is dominant during the first 48 hours after laparoscopic cholecystectomy.…”

“…5 Pain after laparoscopic cholecystectomy depends on multiple factors including rupture of blood vessels caused by rapid distension of the peritoneum, traumatic traction on the nerves, trauma to the abdominal wall during port insertion and GB retrieval and pneumoperitoneum created by use of CO2 to maintain high abdominal pressure. 5 It is reported that incisional pain is more intense than visceral pain and is dominant during the first 48 hours after laparoscopic cholecystectomy. 6 Retrieval of GB is an important terminal event of laparoscopic cholecystectomy and is thought to be one of the factors affecting postoperative port site pain and infection.…”

Randomized controlled study of effectiveness and timings of bupivacaine at port site in managing pain after laparoscopic cholecystectomy

“…22,23 The longer duration of hospitalization in our study can be attributed to other factors related to the surgery, i.e. all patients are inserted abdominal drains as a standard protocol & in our wards removal of the drain is done at the 2 nd to 3 rd day post operatively.…”

Cholecystectomy: evolution of laparoscopic approach

“…Y. Liu и соавт. (2009) у части паци-ентов вводили 20 мл 1% раствора ропивакаина после наложения кожных швов, после чего статистически значимые различия с группой сравнения отсутство-вали [140]. А вот N. Hasaniya и соавт.…”