Pain after a Laparoscopic Cholecystectomy: Comparison between Somatic Pain and Visceral Pain

Kim, Seong Bae; Kong, Myoung Hoon; Lee, Mi Kyoung; Kim, Nan Sook; Choi, Young Seok; Lim, Sang Ho

doi:10.4097/kjae.2001.41.1.66

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…The somatic component of the pain is associated with the apertures made in the abdominal wall for the entry of the trocar. Kim S. B. et al [15] proved that somatic pain after laparoscopic cholecystectomy predominates over visceral pain. Therefore, the multimodal approach with the use of various regional analgesia techniques in laparoscopic surgery can contribute to the improvement of the quality of perioperative analgesia, thus preventing the development of side effects associated with the use of opioids.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of regional analgesia techniques in abdominal surgery patients with obesity

et al. 2018

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The use of regional anesthetic techniques in abdominal surgery is an essential component of the multimodal approach to perioperative analgesia, yet data on their use in obese patients remains limited. The aim of this study is to determine the effectiveness of the epidural analgesia (EA) and the transversus abdominis plane block (TAP-block) in laparoscopic obese patients, as well as to evaluate the possibility of using the rectus sheath block (RSB) as a "rescue" anesthetic technique after laparotomy in obese patients. Materials and methods. The data on the 102 obese patients operated on esophageal hiatal diaphramgmatic hernia, colon tumor, postoperative ventral hernia, morbid obesity and choledocholithiasis were analyzed. In laparoscopic surgery 20 patients received EA (EA group), 21 patients-TAP-block (TAP group), 21 patients-opioids and non-steroidal anti-inflammatory drugs (NSAIDs) without any regional anesthesia techniques (group TIVA 1). In laparotomic surgery 16 patients received RSB (RSB group) and 24 patients-only opioids and NSAIDs (TIVA 2 group). After the surgery the following was estimated: the time of extubation, the total dose of opioids, the level of pain according to the 10-point numeric range score (NRS), the incidence of dyspnea using the monitor Utas 300 (Ukraine), the incidence of postoperative nausea and vomiting (PONV), the time of active patient mobilization, and the level of satisfaction with analgetic regimen. For the RSB group, the complexity of the RSB and the mean time to achieve adequate analgesia (pain intensity ≤3 points per NRS) were determined additionally. The statistical analysis was performed using the Statistica for Windows version 6.0 software. Results. In the EA group, the intraoperative dose of fentanyl was twice lower, and patients were extubated two times faster than in the TAP, TIVA 1 , RSB, TIVA 2 groups (P < 0.05). At the same time, none of the patients in the EA group required the restoration of neuromuscular conduction with neostigmine (P < 0.05). After the surgery, the pain level was 2-3 times higher in the TIVA 1 , RSB, and TIVA 2 groups than in the EA and TAP groups (P < 0.05). "Rescue" analgesia in the RSB group was performed from the first attempt in all the patients in 5-10 minutes and provided an adequate effect in 3 (2-4) min. The complexity level of RSB was defined as "easy" in 12 (75 %) patients, as "average" in 4 (25 %) patients (P < 0.05). The incidence of dyspnea and opioid doses after surgery in the EA, TAP and RSB groups of patients were 2 times lower, and the incidence of PONV was 3 to 4 times lower than in the TIVA 1 and TIVA 2 patients' groups (P < 0.05). In the EA and TAP groups, patients became mobile after 8-13 hours after surgery, in the group TIVA 1-after 16-22 hours, in the group RSB-after 18-36 hours, in the group TIVA 2-after 48-96 hours (P < 0.05). 100 % of the respondents from the EA, TAP and RSB groups were satisfied with the analgesic regimen at the "excellent-good" level. In the TIVA 1 and TIVA 2 groups, 20-25 % of respondents identified...

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Section: Discussionmentioning

confidence: 99%

Efficacy of regional analgesia techniques in abdominal surgery patients with obesity

et al. 2018

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“…Because of viscera-somatic convergence, it is difficult to clinically differentiate somatic and visceral pain [ 10 ]. However, Kim et al [ 11 ] have classified somatic pain as clearly localized pain limited to the peritoneal wall of the surgical site, and visceral pain as dull, nonlocalized, general, squeezing pain. They studied pain patterns in patients lying still in the supine position, and they found that after cholecystectomy by laparoscopy, somatic pain was greater than visceral pain.…”

Section: Discussionmentioning

confidence: 99%

The analgesic effect of ultrasound-guided transverse abdominis plane block after laparoscopic totally extraperitoneal hernia repair

Kim

et al. 2012

Korean J Anesthesiol

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BackgroundThe ultrasound-guided transverse abdominis plane block (TAPB) reduces postoperative pain after laparoscopic abdominal surgery. But, its effect post laparoscopic totally extraperitoneal hernia repair (TEP) is not clear. In this study, we evaluated the analgesic effect of ultrasound-guided TAPB in TEP.MethodsIn this prospective, randomized study, forty adult patients (ASA I-II) scheduled for a TEP under general anesthesia were studied. In the TAPB group (n = 20), an ultrasound-guided bilateral TAPB was performed with 0.375% ropivacaine 15 ml on each side after the induction of general anesthesia. The control group (n = 20) did not have TAPB performed. Fentanyl 50 µg was repeatedly injected as per the patient's request in the recovery room. Pain scores at rest and on coughing were assessed postoperatively in the recovery room (20 min, at discharge) and at 4, 8, and 24 hours after surgery.ResultsIn the recovery room, pain scores (numeric rating scale, 0-10) at postoperative 20 min were lower in the TAPB group (3.9 ± 1.6, 4.9 ± 1.8) than the control group (6.9 ± 1.6, 8.0 ± 1.6) at rest and on coughing. Also, pain scores upon discharge from the recovery room were lower in the TAPB group (3.2 ± 1.2, 4.2 ± 1.5) than the control group (5.3 ± 1.6, 6.5 ± 1.8) at rest and on coughing.ConclusionsThe ultrasound-guided TAPB in patients that had undergone TEP reduced postoperative pain scores and the fentanyl requirement in the recovery room. Also, pain scores on coughing were reduced until postoperative 8 hours.

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“…Laparoscopic cholecystectomy requires three incisions, and patients undergoing such surgery under general anesthesia still experience stress, complaining of severe postoperative pain [4,6] and discomfort during hospitalization. Accordingly, relieving stress, assuaging anxiety, and lessening pain, i.e., ensuring patient comfort, are paramount during postoperative care [6,7].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Aroma Essential Oil Inhalation on Stress, Pain, and Sleep Quality in Laparoscopic Cholecystectomy Patients: A Randomized Controlled Trial

Lee¹,

Hur

2022

Asian Nursing Research

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Purpose: Patients undergoing cholecystectomy report experiencing stress related to the surgery, complaining of pain and poor sleep quality. Aromatherapy is known to have positive effects on these complaints. However, the effect of aromatherapy on cholecystectomy patients has yet to be determined. The aim of this study, therefore, was to investigate the effects of aromatherapy on laparoscopic cholecystectomy patients' stress, pain, and sleep quality. Methods: This study was a randomized controlled trial involving 69 adults who underwent laparoscopic cholecystectomy. Essential oil therapy was given to an intervention group, and almond oil was given to a placebo group. The outcome variables were stress, pain, and sleep quality. Results: There were no differences between the groups in terms of demographic and clinical characteristics and pretreatment dependent variables. After the intervention, subjective stress (F ¼ 7.43, p < .001), objective stress (F ¼ 2.70, p ¼ .034), parasympathetic nerve activity (F ¼ 2.65, p ¼ .036), pain (F ¼ 8.74, p < .001), analgesics administration (F ¼ 22.43, p < .001), and sleep quality (F ¼ 5.23, p < .001) were significantly different between the intervention, placebo, and control groups. Sympathetic nerve activity was not significantly different. The effect sizes regarding the sleep quality of the intervention versus control group and the intervention versus placebo group were 1.92 and 1.52, respectively. Conclusion: Postoperative aromatherapy received by cholecystectomy patients was effective in reducing stress and pain and improving sleep quality. No side effects of aromatherapy were reported during the experimental treatment.

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Pain after a Laparoscopic Cholecystectomy: Comparison between Somatic Pain and Visceral Pain

Cited by 5 publications

References 14 publications

Efficacy of regional analgesia techniques in abdominal surgery patients with obesity

Efficacy of regional analgesia techniques in abdominal surgery patients with obesity

The analgesic effect of ultrasound-guided transverse abdominis plane block after laparoscopic totally extraperitoneal hernia repair

The Effects of Aroma Essential Oil Inhalation on Stress, Pain, and Sleep Quality in Laparoscopic Cholecystectomy Patients: A Randomized Controlled Trial

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