Prospective randomized controlled trial comparing standard analgesia with combined intra-operative cystic plate and port-site local anesthesia for post-operative pain management in elective laparoscopic cholecystectomy

Protić, Mladjan; Veljkovic, Radovan; Bilchik, Anton J.; Popović, Ana; Kresoja, Milena; Nissan, Aviram; Avital, Itzhak; Stojadinovic, Alexander

doi:10.1007/s00464-016-5024-5

Cited by 18 publications

(11 citation statements)

References 65 publications

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“…Pain after a laparoscopic cholecystectomy (LC) is related to abdominal distention, port-site incision, and phrenic nerve irritation due to CO 2 insufflation; therefore, pain felt after removal of the gallbladder has both visceral and somatic origins (3) . Acute postoperative pain is correlated with increased myocardial ischemia, thromboembolic and pulmonary complications, changes in the immune system due to opioid use, an increased hospital stay, an inadequate quality of life, and chronic pain at a rate of 3-56 percent (4,5) .…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy. A Retrospective Cohort Study

Karaca¹,

Pınar²

2020

JARSS

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Objective: Laparoscopic cholecystectomy (LC) causes moderate to severe pain. Although it is a minimal invazive surgery, evaluation of the efficacy and safety of ultrasound guided-bilateral erector spinae plane block (ESPB) in the the present study Method: A total of 234 patients who underwent LCs between April 2017 and November 2018 were retrospectively analyzed. Two hundred patients were divided into two groups: The Control Group (Group C, n=100) who received only intravenous (IV) patient-controlled analgesia (PCA) and the ESPB Group (Group E, n=100) who received bilateral ESPB (bupivacaine 0.25, 50 mL) and IV PCA. Also, the block-related complications were recorded. Results: Numeric rating scores in Grup E were lower in post-anesthesia care unit (PACU) at 1 st , 2 nd , 4 th , 6 th hours (p<0.0001) and 8 th hour (p<0.05). The fentanyl consumption during postoperative period was lower in Group E (p<0.0001). PACU and hospital stay were shorter in Group E (p<0.0001). Need for rescue analgesic was lower in Group E (p<0.0001). Intraoperative fentanyl requirement was lower in Group E (p<0.0001). Unassisted walking time was shorter in Group E (p<0.0001). The incidence of nausea and vomiting was lower in Group E (p<0.05). No block-related complications were encountered. Conclusion:Bilateral ultrasound-guided ESPB provides better analgesia and shortens unassisted walking time and hospital stay after laparoscopic cholecystectomy.

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Section: Introductionmentioning

confidence: 99%

The Efficacy of Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy. A Retrospective Cohort Study

Karaca¹,

Pınar²

2020

JARSS

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“…Previous studies have reported that spinal anesthesia and local peritoneal anesthesia have a lower rate of postoperative complications compared with general anesthesia. 26 - 28 …”

Section: Discussionmentioning

confidence: 99%

The Comparison of Postoperative Pain, Nausea, and Vomiting between Veress Needle Entry and Direct Trocar Entry Methods in Patients Undergoing Laparoscopic Cholecystectomy

Toolabi

Elyasinia

Taftian

et al. 2021

Middle East J Dig Dis

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BACKGROUND Postoperative pain, nausea, and vomiting are the most common side effects of laparoscopic cholecystectomy (LC). In the present study, we investigated the differences in postoperative pain, nausea, and vomiting between Veress needle and direct trocar entry methods among patients undergoing LC. METHODS 96 patients with gallstones were studied. They were randomly divided into two groups: the patients in the first group (n = 48) were insufflated 8.1 liters per minute CO 2 gas by direct trocar port, and the patients in another group (n = 48) were insufflated 2.1 liters per minute CO 2 gas by Veress needle. Pain intensity, nausea, and vomiting were assessed at 20 minutes, 4 hours, and 12 hours after the operations. RESULTS The duration of CO 2 gas insufflation in Veress needle was 88.7 ± 10.7 seconds and indirect trocar was 16.6 ± 1.6 seconds. Visual analog scale (VAS) score significantly reduced in Veress needle compared with direct trocar (0.39 ± 0.98 vs. 1.68 ± 1.48) at 20 min after the operation, while there was no difference at 4 hours and 12 hours after the operation. The requirement and dose of pethidine injection were significantly lower in Veress needle than direct trocar. In addition, nausea and vomiting occurred in Veress needle less than direct trocar at 20 min, 4 hours, and 12 hours after LC. CONCLUSION Pain intensity just in the short term after LC in the group with CO 2 gas insufflation in Veress needle was significantly less than the other group, while nausea and vomiting were significantly less during the whole follow-up periods in the group with CO 2 gas insufflation in Veress needle.

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“…The effect of intraperitoneal LA was examined in 12 studies, [81][82][83][84][85][86][87][88][89][90][91][92] which demonstrated no change in LOS (p = 0.200) or day case rates (p = 0.110). A total of five studies 81,[93][94][95][96] were found examining the effect of combined intraperitoneal and incisional LA and this likewise did not show a significant reduction (p = 0.060). Three studies [97][98][99] examined the effect of intraoperative transversus abdominis plane (TAP) blocks versus no TAP blocks and systematic review found no difference in LOS or day case rate.…”

Section: Local/regional Anaesthesiamentioning

confidence: 96%

Systematic review and meta-analysis of factors which reduce the length of stay associated with elective laparoscopic cholecystectomy

Ryan

OʼConnell

Rogers

et al. 2021

HPB

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Background Laparoscopic cholecystectomy is a safe ambulatory procedure in appropriately selected patients; however, day case rates remain low. The objective of this systematic review and meta-analysis was to identify interventions which are effective in reducing the length of stay (LOS) or improving the day case rate for elective laparoscopic cholecystectomy. Methods Comparative English-language studies describing perioperative interventions applicable to elective laparoscopic cholecystectomy in adult patients and their impact on LOS or day case rate were included. Results Quantitative data were available for meta-analysis from 80 studies of 10,615 patients. There were an additional 17 studies included for systematic review. The included studies evaluated 14 peri-operative interventions. Implementation of a formal day case care pathway was associated with a significantly shorter LOS (MD = 24.9 h, 95% CI, 18.7–31.2, p < 0.001) and an improved day case rate (OR = 3.5; 95% CI, 1.5–8.1, p = 0.005). Use of non-steroidal anti-inflammatories, dexamethasone and prophylactic antibiotics were associated with smaller reductions in LOS. Conclusion Care pathway implementation demonstrated a significant impact on LOS and day case rates. A limited effect was noted for smaller independent interventions. In order to achieve optimal day case targets, a greater understanding of the effective elements of a care pathway and local barriers to implementation is required.

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Prospective randomized controlled trial comparing standard analgesia with combined intra-operative cystic plate and port-site local anesthesia for post-operative pain management in elective laparoscopic cholecystectomy

Cited by 18 publications

References 65 publications

The Efficacy of Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy. A Retrospective Cohort Study

The Efficacy of Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy. A Retrospective Cohort Study

The Comparison of Postoperative Pain, Nausea, and Vomiting between Veress Needle Entry and Direct Trocar Entry Methods in Patients Undergoing Laparoscopic Cholecystectomy

Systematic review and meta-analysis of factors which reduce the length of stay associated with elective laparoscopic cholecystectomy

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