Does Preincisional Infiltration with Bupivacaine Reduce Postoperative Pain in Laparoscopic Bariatric Surgery?

Abstract

The present study did not conclusively prove the efficacy of bupivacaine infiltration by any of the three evaluation methods analyzed. Nevertheless, preincisional infiltration provides good level of comfort in the immediate postoperative period when analgesia is most urgent.

Factors affecting the surgeon preference for bolus opioid use to control postoperative pain after bariatric surgery

“…Different local and regional pain management strategies are now being used by surgeons and anesthesiologists to reduce opioid use, including local anesthesia administration at the trocar incision site, TAP block, epidural block, and other types of truncal blocks [17]. In our study, the most preferred local method involved the use of local anesthesia at trocar incision site in line with the published literature.…”

“…In our study, the most preferred local method involved the use of local anesthesia at trocar incision site in line with the published literature. The reasons for its frequent use include the low cost and practicality, as well as the fact that it does not require ultrasound or any other special equipment and knowledge [17]. Other types of truncal or epidural blocks may pose specific challenges in patients with morbid obesity, including the requirement to pinpoint anatomical landmarks using both manual and ultrasonographic techniques.…”

Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

“…In bariatric patients, WI could be a prudent opioid-sparing option [154]. However, single-shot pre-incision WI bupivacaine (0.5%) with epinephrine was not an effective analgesic strategy for patients undergoing laparoscopic bariatric surgery [155]. Dexmedetomidine as adjuvant to ropivacaine enhanced the analgesic efficacy of ropivacaine WI, reduced 24-h sufentanil consumption and had no adverse effect on wound healing in patients undergoing open gastrectomy [156].…”

Pain Management in Weight Loss Surgery: Aiming for Multimodal Approach

“…A different finding was achieved in a retrospective randomized study where VAS scores were lower in the study group (bupivacaine infiltration) in the first 4 h postoperatively without reaching statistical significance and did not differ in any other period of time. Also, no statistically significant differences in pain perception or the need for rescue medication were evidenced [13]. Table 3: Multimodal Analgesia Protocol Lam et al [22].…”