Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery

Stuhldreher, Jacquelenn; Adamina, Michel; Konopacka, Alex; Brady, Karen; Delaney, Conor P.

doi:10.1007/s00464-011-2079-1

Cited by 19 publications

(8 citation statements)

References 21 publications

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“…A recent study by Kahokehr et al reported that instillation and infusion of ropivacaine provided reduced postoperative pain and less opioid analgesic requirements when compared to the placebo group following colonic resection [9]. However, a study by Stuhldreher et al concluded that intraperitoneal local anesthetic instillation did not improve postoperative pain scores or opioid requirements in patients undergoing laparoscopic colorectal procedures [16]. Indeed, other previous studies reported little additional benefit to intraperitoneal bupivacaine on pain scores beyond 2 h postoperatively [17], or indeed no benefit at all [18].…”

Section: Discussionmentioning

confidence: 99%

Aerosolized Intraperitoneal Local Anesthetic for Laparoscopic Surgery: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Aerosolized Intraperitoneal Local Anesthetic for Laparoscopic Surgery: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

et al. 2015

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“…Local infiltration of the wound and parietal peritoneum is another pain control tool that could benefit patients undergoing laparoscopic colorectal surgery [23,24]. Local infiltration using regular bupivacaine has not been shown to reduce pain scores, PACU time, postoperative opioid consumption, or length of stay [25]. Local infiltration using LB has been described for reducing postoperative pain and opioid consumption in hemorrhoidectomy, hernia, stoma reversals, and open colectomy procedures [26][27][28][29][30][31].…”

mentioning

confidence: 99%

Pilot study of a novel pain management strategy: evaluating the impact on patient outcomes

et al. 2015

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Our multimodal pain management strategy reduced intraoperative opioid administration. Postoperatively, improvements in PACU time, postoperative pain and narcotic use, and lengths of stay were seen in the experimental cohort. With the favorable finding from the pilot study, further investigation is warranted to fully evaluate the impact of this pain management protocol on patient satisfaction, clinical and financial outcomes.

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“…Other pharmacological and nonpharmacological treatments might also be used in order to decrease morphine consumption. In adults patients intravenous lidocaine,[18] preoperative gabapentin[192021] or intraperitoneal or wound local anesthetics administration[18222324] have been previously found to decrease postoperative opioid requirement and improve postoperative pain relieve. However, their use in children is limited by the lack of evidences.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting recovery of postoperative bowel function after pediatric laparoscopic surgery

Michelet

Andreu-Gallien²,

Skhiri

et al. 2016

J Anaesthesiol Clin Pharmacol

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Background and Aims:Laparoscopic pediatric surgery allows a rapid postoperative rehabilitation and hospital discharge. However, the optimal postoperative pain management preserving advantages of this surgical technique remains to be determined. This study aimed to identify factors affecting the postoperative recovery of bowel function after laparoscopic surgery in children.Material and Methods:A retrospective analysis of factors affecting recovery of bowel function in children and infants undergoing laparoscopic surgery between January 1, 2009 and September 30, 2009, was performed. Factors included were: Age, weight, extent of surgery (extensive, regional or local), chronic pain (sickle cell disease or chronic intestinal inflammatory disease), American Society of Anaesthesiologists status, postoperative analgesia (ketamine, morphine, nalbuphine, paracetamol, nonsteroidal anti-inflammatory drugs [NSAIDs], nefopam, regional analgesia) both in the Postanesthesia Care Unit and in the surgical ward; and surgical complications. Data analysis used classification and regression tree analysis (CART) with a 10-fold cross validation.Results:One hundred and sixty six patients were included in the analysis. Recovery of bowel function depended upon: The extent of surgery, the occurrence of postoperative surgical complications, the administration of postoperative morphine in the surgical ward, the coadministration of paracetamol and NSAIDs and/or nefopam in the surgical ward and the emergency character of the surgery. The CART method generated a decision tree with eight terminal nodes. The percentage of explained variability of the model and the cross validation were 58% and 49%, respectively.Conclusion:Multimodal analgesia using nonopioid analgesia that allows decreasing postoperative morphine consumption should be considered for the speed of bowel function recovery after laparoscopic pediatric surgery.

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Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery

Abstract: Use of local anesthetic does not influence postoperative opioid requirements or patients' subjective report of pain following laparoscopic colorectal procedures managed within enhanced recovery care pathways.

Cited by 19 publications

References 21 publications

Aerosolized Intraperitoneal Local Anesthetic for Laparoscopic Surgery: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

Aerosolized Intraperitoneal Local Anesthetic for Laparoscopic Surgery: A Randomized, Double‐Blinded, Placebo‐Controlled Trial

Pilot study of a novel pain management strategy: evaluating the impact on patient outcomes

Factors affecting recovery of postoperative bowel function after pediatric laparoscopic surgery

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