Comparing the Impact of Intraperitoneal Hydrocortisone With Bupivacaine on Postoperative Pain After Laparoscopic Cholecystectomy

Amini, Shahram; Sarvestani, Amene Sabzi

doi:10.5812/aapm.17206

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…studied the analgesic effect of intraperitoneal injection of hydrocortisone alone prior to gas insufflation in laparoscopic cholecystectomy, and they found that intraperitoneal hydrocortisone can decrease postoperative pain without postoperative complications, which is in parallel to the results of the current study. [ 16 ] Furthermore, our results agreed with Asgari et al . who studied the additive effect of intraperitoneal hydrocortisone and bupivacaine on postoperative pain in gynecological surgery, and they found that hydrocortisone with bupivacaine has a greater analgesic effect than bupivacaine only.…”

Section: Discussionsupporting

confidence: 93%

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Effect of adding hydrocortisone to intraperitoneal bupivacaine in laparoscopic bariatric surgery

et al. 2020

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Background: Bariatric surgery is the effective management of obesity; however, postoperative pain is associated with a great morbidity. The management of pain is important for the enhancement of patient recovery. Local anesthetics can be injected during laparoscopic surgery into the peritoneum throughout the ports produced either before the beginning of laparoscopy or before the closure of the wound to reduce postoperative pain. Our aim is to evaluate if there is an additive analgesic effect by the administration of intraperitoneal hydrocortisone with streamed intraperitoneal bupivacaine as a method of postoperative pain relief in laparoscopic bariatric surgeries. Patients and Methods: One hundred patients listed for laparoscopic bariatric surgery were the subject of this study. Patients were randomly allocated into two groups: Group I received 100 mg of 0.5% isobaric bupivacaine plus 20 mL normal saline intraperitoneally and Group II received intraperitoneal 100 mg of 0.5% isobaric bupivacaine + 100 mg hydrocortisone + 20 mL of saline at the end of the laparoscopic procedure. The primary outcome was the Visual Analog Scale (VAS) score for pain. The secondary outcomes were the time of first analgesic request, total opioid requirement, heart rate, and mean blood pressure. Results: VAS showed a significant decrease at 4, 6, and 12 h postoperative in Group II compared to Group I. There was a marked decrease in total meperidine requirement with prolonged time of the first analgesic request in Group II compared to Group I. Conclusion: Intraperitoneal hydrocortisone with bupivacaine had improved postoperative pain relief with a decrease in analgesic requirement.

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Section: Discussionsupporting

confidence: 93%

“…who studied hydrocortisone versus bupivacaine; this difference may be explained by the use of drug combination in our study instead of hydrocortisone alone in the previous study. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

Effect of adding hydrocortisone to intraperitoneal bupivacaine in laparoscopic bariatric surgery

et al. 2020

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“…The patients were similar regarding postoperative analgesic requirements, return of bowel function, nausea, and vomiting. [ 17 ] In a similar study, Zahra Asgari et al . studied the effect of dexamethasone added to intra-peritoneal bupivacaine on postoperative pain after gynaecological surgery and concluded that combination to be more effective than bupivacaine alone.…”

Section: Discussionmentioning

confidence: 87%

Postoperative analgesic efficacy of the pulmonary recruitment manoeuvre compared to intraperitoneal hydrocortisone in laparoscopic gynaecological surgeries

et al. 2021

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Background and Aims: Laparoscopic surgeries are becoming attractive because of early recovery. Adequate postoperative pain relief may be a major concern. Several methods have been used to relieve laparoscopic postoperative pain. Methodology: This prospective, randomised, controlled study was conducted during the period between February and June 2019. Patients were assigned into three groups. Patients in the hydrocortisone group received intraperitoneal 100mg hydrocortisone in 150 ml normal saline together with the routine method to remove carbondioxide (CO2). For patients in the pulmonary recruitment group, CO 2 was exsufflated by pulmonary recruitment manoeuvre together with the routine method to remove CO 2 . In the control group CO 2 was removed by applying gentle abdominal pressure allowing passive exsufflation through the port site. Results: A total of 57 patients were included in the study. There was no statistically significant difference between the three groups as regards demographic characteristics. There was a statistically significant difference in the 24 h postoperative analgesic consumption (primary outcome) in the hydrocortisone and pulmonary recruitment groups in comparison to the control group:P value <0.001. Also, time to first request for analgesia was significantly longer and the visual analogue scale (VAS) score was significantly lower in the hydrocortisone and pulmonary recruitment groups compared to the control group:P value <0.001. Conclusion: Intraperitoneal hydrocortisone and pulmonary recruitment manoeuvre could both effectively reduce pain after gynaecological laparoscopic surgeries, however, intraperitoneal hydrocortisone might give a longer pain-free time.

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“…Sarvestani et al determined the amount of pneumoperitoneum that was still present 24 hours after LC by using chest X-rays in their calculation. [10] Several further randomised studies revealed that the operating periods of SPCP and LPCP LC were comparable. According to a meta-analysis, LPCP LC surgery takes two minutes longer than SPCP.…”

Section: Discussionmentioning

confidence: 98%

Low-Pressure Laparoscopic Surgery is a Viable and Risk-Free Alternative to Standard Pressure for the Treatment of Benign Gall Stone

Ali¹,

Naz²,

Sayyed³

et al. 2023

PJMHS

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When compared to the open cholecystectomy, laparoscopic cholecystectomy (LC) has the benefits of less post-operative pain and quicker return to work. However, up to 80% of individuals after laparoscopic surgery still experience significant pain and needing pain relief. Methodology: The reason for this research was to compare the results of LC performed with and without LPP. LC requires the surgeon to choose a pneumoperitoneum pressure that maximizes working space while avoiding unintended side effects. This study used a Randomized Controlled Trial (RCT) design, and it was done at the West Surgical Ward at Mayo Hospital in Lahore. The study enrolled 60 participants who met the inclusion criteria. The patients were split in two groups: Low-pressure pneumoperitoneum-LPP (Group A) (06-10 mm of Hg) and pneumoperitoneum at standard pressure (SPP) is part of Group B. (12-16 mm of Hg). All had opted for a LC to treat their symptomatic gallstone disease. At 4, 8, and 24 hours following surgery, the severity of postoperative shoulder pain (if present) was evaluated using a visual analogue pain scale (VAS). The frequency of postoperative nausea and vomiting was assessed at 4, 8, 12, and 24 hours. Results: The patients were 35.63 years old on average. Majority of these two groups has no complications. Based on the data, we discovered that the frequency of episodes of nausea/vomiting in both groups was very low and that only a few patients had bouts of nausea/vomiting in the 4 hours and 24 hour time intervals. Conclusion: We have come to the conclusion that LP laparoscopic surgery is a viable and risk-free alternative to SP laparoscopic operation for the treatment of benign gall stone disorders. Our findings lead us to the conclusion that LPP is a superior option for the LC since it reduces the post-operative pain in the shoulder and the risk of PONV while not significantly increasing the risk of intraoperative complications. Keywords: Benign Gall Stone, Treatment, Low-Pressure Laparoscopic Surgery,

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Comparing the Impact of Intraperitoneal Hydrocortisone With Bupivacaine on Postoperative Pain After Laparoscopic Cholecystectomy

Cited by 7 publications

References 27 publications

Effect of adding hydrocortisone to intraperitoneal bupivacaine in laparoscopic bariatric surgery

Effect of adding hydrocortisone to intraperitoneal bupivacaine in laparoscopic bariatric surgery

Postoperative analgesic efficacy of the pulmonary recruitment manoeuvre compared to intraperitoneal hydrocortisone in laparoscopic gynaecological surgeries

Low-Pressure Laparoscopic Surgery is a Viable and Risk-Free Alternative to Standard Pressure for the Treatment of Benign Gall Stone

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