Effectiveness of local anesthetic application methods in postoperative pain control in laparoscopic cholecystectomies; a randomised controlled trial

Ergin, Anıl; Aydın, Mehmet Timuçin; Çiyiltepe, Hüseyin; Karip, Aziz Bora; Fersahoğlu, Mehmet Mahir; Özcabı, Yetkin; Ağca, Birol; İşcan, Yalın; Güneş, Yasin; Ar, Arzu Yıldırım; Taşdelen, İksan; Memışoğlu, Kemal

doi:10.1016/j.ijsu.2021.106134

Cited by 11 publications

(11 citation statements)

References 32 publications

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“…No differences in the hospital LOS were found in the remaining nine trials. These studies evaluated intraperitoneal instillation compared to placebo (five trials) [ 21 , 23 , 33 , 48 , 66 ], rectus sheath block compared to placebo (one trial) [ 67 ], paravertebral block compared to placebo (one trial) [ 73 ], wound/port infiltration compared to TAP block [ 90 ], and intraperitoneal instillation compared to TAP block compared to wound/port infiltration compared to placebo (one study) [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

Single-shot regional anesthesia for laparoscopic cholecystectomies: a systematic review and network meta-analysis

Cassai

Sella

Geraldini

et al. 2023

Korean J Anesthesiol

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Section: Resultsmentioning

confidence: 99%

Single-shot regional anesthesia for laparoscopic cholecystectomies: a systematic review and network meta-analysis

Cassai

Sella

Geraldini

et al. 2023

Korean J Anesthesiol

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“…Compared with the other two groups, a higher proportion of those who received Ropivacaine at low concentrations (0.25%) required rescue anesthesia in the ward (5 (16.7%) [ 88 ]. The values of the control group VAS were significantly higher than those of the groups TAI, TAPB, and IPLA after 1, 2, 4, 6, 12, and 24 h [ 90 ]. In addition, the VAS values of the IPLA group were significantly higher than those of the LAI and TAPB groups at 1, 2, 4, 6, 12, and 24 h [ 90 ].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The values of the control group VAS were significantly higher than those of the groups TAI, TAPB, and IPLA after 1, 2, 4, 6, 12, and 24 h [ 90 ]. In addition, the VAS values of the IPLA group were significantly higher than those of the LAI and TAPB groups at 1, 2, 4, 6, 12, and 24 h [ 90 ]. VAS values at 1, 2, 4, 6, and 24 h were not significantly different between TAI and the TAPB group.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Transversus Abdominis Plane Block as a Strategy for Effective Pain Management in Patients with Pain during Laparoscopic Cholecystectomy: A Systematic Review

Alsharari

Abuadas

Alnassrallah

et al. 2022

JCM

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Laparoscopic cholecystectomy (LC), unlike laparotomy, is an invasive surgical procedure, and some patients report mild to moderate pain after surgery. Transversus abdominis plane (TAP) block has been shown to be an appropriate method for postoperative analgesia in patients undergoing abdominal surgery. However, there have been few studies on the efficacy of TAP block after LC surgery, with unclear information on the optimal dose, long-term effects, and clinical significance, and the analgesic efficacy of various procedures, hence the need for this review. Five electronic databases (PubMed, Academic Search Premier, Web of Science, CINAHL, and Cochrane Library) were searched for eligible studies published from inception to the present. Post-mean and standard deviation values for pain assessed were extracted, and mean changes per group were calculated. Clinical significance was determined using the distribution-based approach. Four different local anesthetics (Bupivacaine, Ropivacaine, Lidocaine, and Levobupivacaine) were used at varying concentrations from 0.2% to 0.375%. Ten different drug solutions (i.e., esmolol, Dexamethasone, Magnesium Sulfate, Ketorolac, Oxycodone, Epinephrine, Sufentanil, Tropisetron, normal saline, and Dexmedetomidine) were used as adjuvants. The optimal dose of local anesthetics for LC could be 20 mL with 0.4 mL/kg for port infiltration. Various TAP procedures such as ultrasound-guided transversus abdominis plane (US-TAP) block and other strategies have been shown to be used for pain management in LC; however, TAP blockade procedures were reported to be the most effective method for analgesia compared with general anesthesia and port infiltration. Instead of 0.25% Bupivacaine, 1% Pethidine could be used for the TAP block procedures. Multimodal analgesia could be another strategy for pain management. Analgesia with TAP blockade decreases opioid consumption significantly and provides effective analgesia. Further studies should identify the long-term effects of different TAP block procedures.

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“…Transdermal fentanyl patches are used by more than half of the patients and have been useful. Only six out of 100 patients received an epidural, revealing the fact that the anesthetic population is moving away from central neuraxial techniques due to the potential complications associated with it, particularly when there are safer alternatives available [9][10][11][12]. Even out of the six epidural infusions, four were stopped due to hypotension.…”

Section: Postoperative Pain-related Variables (Number (%))mentioning

confidence: 99%

An Observational Study to Assess Postoperative Pain Control and Formulate a Comprehensive Approach to the Implementation of Policy Change for Pain Control in Postoperative Units

Venkatesan¹,

Thulasiraman²,

Kesavan³

et al. 2022

Cureus

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Background Postoperative pain control irrespective of the magnitude of surgery has always remained a challenge for clinicians and healthcare workers. Good postoperative pain control is pivotal for unremarkable recovery and shorter hospital stays. Unfortunately, there is no uniform approach across the globe to address postoperative pain control. This provoked our thought to conduct a prospective observational study in our center to assess the already existing efficacy of pain management. Materials and methods This is a prospective observational study conducted in a tertiary care center in Coimbatore, India. The aim of this study is to assess the efficacy of an ongoing pain management system to compare it with standards in the literature to introduce changes and re-examine the results. A total of 100 patients who underwent major surgical procedures from various specialities were included after satisfying the inclusion criteria. The study was conducted over a period of four months to collect data from patients in the postoperative ward. Data were collected, pain-related variables were tabulated, and deficits were identified. Standardized pain assessment tools were not used. The results suggested the need for a policy change for quality improvement. This article gives reports on initial study results and plans to address the deficits in the current pain management system. A systematic and schematic approach for the implementation of the policy change and the framework for the new acute pain service team aiming at quality improvement have been discussed in detail. Results The results show that 28 patients were prescribed only routine paracetamol and rescue nonsteroidal anti-inflammatory drugs (NSAIDs). At rest, 56 patients had some pain, and 29 complained of moderate to severe pain. On movement, only seven patients had no pain, 48 had mild pain, and 45 had moderate to severe pain. Only 12 patients out of 100 had good sleep, 27 had moderate, and 43 had little sleep. Twelve patients had no sleep due to continuous ongoing pain in spite of ongoing pain control modalities. Sixteen patients complained of undue delay in receiving their analgesics. Twenty-two patients were dissatisfied, and 44 suggested the need for improvement of current pain control strategies. These data clearly suggest that the pain control strategies are inadequate and need improvement undoubtedly for quality improvement. The Wendy Hirsch model is chosen to create a framework for implementing a new change, and a detailed report is done to present to the hospital quality control department. These changes will be done after the approval, and a post-implementation outcome will be studied. Conclusion Good postoperative pain control is of paramount significance for both patients and healthcare professionals. With the current availability of various pain relief modalities, one should consider establishing a pain control pathway, if possible an acute pain team with a systematic a...

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Effectiveness of local anesthetic application methods in postoperative pain control in laparoscopic cholecystectomies; a randomised controlled trial

Cited by 11 publications

References 32 publications

Single-shot regional anesthesia for laparoscopic cholecystectomies: a systematic review and network meta-analysis

Single-shot regional anesthesia for laparoscopic cholecystectomies: a systematic review and network meta-analysis

Transversus Abdominis Plane Block as a Strategy for Effective Pain Management in Patients with Pain during Laparoscopic Cholecystectomy: A Systematic Review

An Observational Study to Assess Postoperative Pain Control and Formulate a Comprehensive Approach to the Implementation of Policy Change for Pain Control in Postoperative Units

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