A randomized, double-blinded trial of preemptive analgesia in laparoscopy

Abstract

The preemptive administration of bupivacaine before laparoscopy results in decreased postoperative pain and should allow a more rapid return to normal activities. The popular practice of infiltrating bupivacaine at time of incision closure does not offer any benefit in the control of pain after laparoscopy.

To assess the role of multisite instillation of bupivacaine-xylocaine combination for reducing post-operative pain after elective laparoscopic cholecystectomy

“…8 In a study of Ke et al preemptive analgesia using 0.5% bupivacaine was found to be superior to postsurgical analgesia at 24 hours postoperatively. 9 A study by Saleh ET al found significant differences in pain levels only at 30 minutes after surgery when comparing preemptive analgesia using 0.5% bupivacaine with placebo. 10 This study did not evaluate use of postsurgical analgesia.…”

Superior Somatic Pain Relief and Improved Visceral Pain Control Is Achieved Using Pre-Emptive Analgesia for Laparoscopic Cholecystectomy: A Randomized Controlled Trial

“…(12). The role of using preemptive analgesia in surgical setting has been widely studied and applied in various disciplines by surgeons, obstetrician and gynaecologists (13). Its use ranges from simple administration of oral analgesic to local anaesthetic infiltration and, at times the use of more invasive procedures such as epidural or nerve blocks have been reported.…”

Analgesia preemptiva

“…Conversely, Ejlersen et al 60 studying patients submitted to inguinal herniorrhaphy concluded that pre-incisional 1% lidocaine infiltration was more effective in relieving postoperative pain than post-incisional infiltration. Ke et al 61 also observed preemptive effects in women submitted to diagnostic laparoscopy who received infiltration of 0.5% bupivacaine at incision site before surgical stimulation. In 120 patients submitted to laparoscopic cholecystectomies, Pasqualucci et al 62 used peritoneal instillation of 0.5% bupivacaine with epinephrine before or after surgery.…”