Pre-incisional Laparoscopic Preperitoneal Local Anesthetic Technique in Laparoscopic Sleeve Gastrectomy

Abstract

Background: The increasing prevalence of obesity is a significant concern worldwide. Laparoscopic sleeve gastrectomy (LSG) is an effective and standard procedure for sustained weight loss. However, optimal pain control is essential for enhanced recovery after surgery. The aim of this randomized controlled study was to investigate the efficacy of a pre-incisional laparoscopic preperitoneal local anesthetic technique (PLPLAT) on recovery characteristics following LSG. Methods: A total of 120 obese patients scheduled to undergo LSG were randomized into the PLPLAT or placebo group (n = 60 patients in both groups). All patients received conventional intravenous or other analgesics postoperatively, as required. The primary outcome was the postoperative pain score. The secondary outcomes included morphine consumption, other analgesics, length of stay in the postanesthesia care unit (PACU), hemodynamic changes, postoperative nausea and vomiting (PONV), early mobilization, and length of hospital stay. Results: Pain scores in the PACU and at 12 hours after surgery in the ward were significantly lower in the PLPLAT group than in the placebo group (P < 0.05). The morphine consumption was significantly less in PLPLAT group with mean dosage of 2.95 mg (± 0.39) compared to 6.0 mg (± 0.4) in placebo group. PONV, mean arterial pressure, and PACU stay were significantly higher in the placebo group than in the PLPLAT group (P < 0.05). Conclusion: Intraoperative PLPLAT provide effective postoperative pain relief for patients undergoing LSG. The findings indicated the efficacy of PLPLAT in reducing postoperative pain, enhancing recovery, and facilitating early discharge.

Transversus Abdominis Plane with Rectus Sheath Blocks versus Port Site Infiltration of Local Anaesthesia in Emergency Laparoscopic Cholecystectomy. Does It Reduce Postoperative Opiate Requirement? A Pilot Study

“…Similarly, regular versus PRN paracetamol and ibuprofen may have also affected the total amount provided to patients within their given timeframe. Lastly, a study by Aldohayan demonstrated that intraoperative pre-incisional laparoscopic preperitoneal local anaesthetic infiltration was significantly associated with reduced pain scores in the PACU [16]. This differs from our study in which LA was placed at port sites at the end of the case, prior to skin closure.…”