Preincisional intravenous low-dose ketamine and local infiltration with ropivacaine reduces postoperative pain after laparoscopic cholecystectomy

Papaziogas, B.; Argiriadou, Helena; Papagiannopoulou, P.; Pavlidis, Theodosios; Georgiou, M.; Sfyra, E.; Papaziogas, T.

doi:10.1007/s004640090124

Cited by 36 publications

(22 citation statements)

References 15 publications

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“…CO2 remains in the peritoneal cavity for several days after surgery and causes stretching of the phrenic nerve endings [15] , local hypothermia, and diaphragmatic irritation via carbonic acid [16] . The benefit of using intraperitoneal local anesthetics for shoulder and abdominal pain control has been proven [7,[17][18][19] , however, several other studies did not confirm these findings [20][21][22][23] . Pain after LC includes three components, visceral, parietal, and shoulder pain [3] .…”

Section: Discussionmentioning

confidence: 99%

Effect of implanting fbrin sealant with ropivacaine on painafter laparoscopic cholecystectomy

Fu¹,

Li²,

Yu³

2009

WJG

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AIM:To investigate the safety and efficacy of implanting fibrin sealant with sustained-release ropivacaine in the gallbladder bed for pain after laparoscopic cholecystectomy (LC). METHODS:Sixty patients (American Society of Anesthesiologists physical status was Ⅰ or Ⅱ and underwent LC) were randomly divided into three equal groups: group A (implantation of fibrin sealant in the gallbladder bed), group B (implantation of fibrin sealant carrying ropivacaine in the gallbladder bed), and group C (normal saline in the gallbladder bed). Postoperative pain was evaluated, and pain relief was assessed by visual analog scale (VAS) scoring. RESULTS:The findings showed that 81.7% of patients had visceral pain, 50% experienced parietal, and 26.7% reported shoulder pain after LC. Visceral pain was significantly less in group B patients than in the other groups (P < 0.05), and only one patient in this group experienced shoulder pain. The mean VAS score in group B patients was lower than that in the other groups. CONCLUSION:Visceral pain is prominent after LC and can be effectively controlled by implanting fibrin sealant combined with ropivacaine in the gallbladder bed.

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Section: Discussionmentioning

confidence: 99%

Effect of implanting fbrin sealant with ropivacaine on painafter laparoscopic cholecystectomy

Fu¹,

Li²,

Yu³

2009

WJG

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“…2B). Seven study arms did not report time to first analgesic request; the remaining study arm reported a significant benefit for incisional analgesia versus placebo [115]. Two study arms did not report on the use of supplementary analgesics [164]; of the remaining six study arms, two reported a significant benefit for incisional analgesia versus control [83,115].…”

Section: Incisional Local Anestheticmentioning

confidence: 87%

“…The studies evaluated ropivacaine [115] and bupivacaine [83,135,162,164]. Qualitative analysis of VAS scores revealed that five study arms reported a significant benefit for incisional analgesia [83,115,135,164], whereas three reported no significant difference between incisional analgesia and placebo [83,135,162].…”

Section: Incisional Local Anestheticmentioning

confidence: 99%

A procedure-specific systematic review and consensus recommendations for postoperative analgesia following laparoscopic cholecystectomy

Kehlet

Gray²,

Bonnet

et al. 2005

Surg Endosc

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“…It has been shown that preincisional infiltration anesthesia with subanesthetic ketamine increases block time, thereby decreasing postoperative analgesic demand (7). The use of ketamine alone as a preventative analgesic remains questionable (8,9).…”

Section: Introductionmentioning

confidence: 99%

The effect of addition of ketamine to lidocaine on postoperative pain in rhinoplasties

Şanlı¹,

Gülhaş²,

Bt³

et al. 2016

Turk J Med Sci

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IntroductionRhinoplasty is a reconstructive surgery that is frequently performed to correct nasal deformities. Local anesthesia alone or local and general anesthesia together can be used in this procedure. Patients experience distinct pain for 3 days after the operation, which is especially severe during the first day (1). Good analgesia should be provided during the postoperative period in order to ensure patient compliance and comfort (2). Local anesthesia is frequently used because it also contributes to analgesia. The addition of vasoconstrictors and adjuvant agents to local anesthetics reduces side effects and facilitates analgesic effect and duration with reduced local anesthetic concentrations. Epinephrine increases the duration of local anesthesia and provides good exposure (3). Agents such as neostigmine, clonidine, or opioids may also be added to increase the duration of anesthesia. However, neostigmine and opioids are not suited for rhinoplasties because they may cause nausea and vomiting, and clonidine is unavailable in many countries (4,5). Therefore, ketamine and its enantiomers are frequently used in multimodal anesthesia approaches. Ketamine has been shown to be better among other adjuvant agents in terms of efficacy and safety, pharmacokinetics, and pharmacodynamics (6).Ketamine allows preventative analgesia via 2 mechanisms: central desensitization due to antihyperalgesic effect and pain control as an N-methyl-daspartate antagonist. It has been shown that preincisional infiltration anesthesia with subanesthetic ketamine increases block time, thereby decreasing postoperative analgesic demand (7). The use of ketamine alone as a preventative analgesic remains questionable (8,9).Lidocaine-epinephrine combinations are used frequently in addition to general anesthesia for intranasal infiltration during rhinoplasty, but, to date, there is no published study on the effect of added ketamine. The objective of our study was to determine the usefulness of subanesthetic ketamine as an adjuvant to the infiltration block in terms of postoperative pain scores, analgesic demand, and patient satisfaction.Background/aim: The objective of this study was to examine the effect of addition of subanesthetic doses of ketamine to an epinephrinelidocaine solution on postoperative pain, analgesic use, and patient comfort during rhinoplasties.Materials and methods: Ninety patients were randomly divided into three groups: Group L, lidocaine with epinephrine; Group K, lidocaine with epinephrine plus ketamine; and Group S (control group), physiological saline solution with epinephrine. The local anesthetic solution was injected as preincisionally with intranasal submucosal infiltration following induction of general anesthesia. We evaluated visual pain score, analgesic demand, Wilson sedation score, and antiemetic demand at 5, 15, and 30 min and 1, 2, 4, 6, 8, 16, and 24 h after the operation. The patient satisfaction score was checked 24 h after the operation.Results: Visual pain score was significantly reduced in Group K in ...

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Preincisional intravenous low-dose ketamine and local infiltration with ropivacaine reduces postoperative pain after laparoscopic cholecystectomy

Abstract: Preincisional treatment with low-dose IV ketamine and local infiltration with ropivacaine 1% reduces postoperative pain after laparoscopic cholecystectomy.

Cited by 36 publications

References 15 publications

Effect of implanting fbrin sealant with ropivacaine on painafter laparoscopic cholecystectomy

Effect of implanting fbrin sealant with ropivacaine on painafter laparoscopic cholecystectomy

A procedure-specific systematic review and consensus recommendations for postoperative analgesia following laparoscopic cholecystectomy

The effect of addition of ketamine to lidocaine on postoperative pain in rhinoplasties

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