Efficacy of thoracic epidural analgesia for laparoscopic cholecystectomy

Erol, Demet Doğan; Yılmaz, Sezgin; Polat, Coşkun; Arıkan, Yüksel

doi:10.1007/s12325-008-0005-2

Cited by 34 publications

(28 citation statements)

References 33 publications

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“…IV-PCA, while useful, has the side effects of opioids [4]. Though the analgesic effect of patient-controlled thoracic epidural analgesia is better than that of IV-PCA [5], there is a potential risk of dural puncture, infection, and epidural hematoma, as well as muscle weakness, which may cause even paralysis of respiratory muscles [6,7]. An intraperitoneal injection of local anesthetics also has the problems of insufficient pain control and short duration of analgesia [8,9].…”

Section: Introductionmentioning

confidence: 99%

The analgesic effect of the ultrasound-guided transverse abdominis plane block after laparoscopic cholecystectomy

Suk

Kim

Lee

et al. 2010

Korean J Anesthesiol

133

138

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BackgroundSeveral methods are performed to control the pain after a laparoscopic cholecystectomy. Recently, the transverse abdominis plane block has been proposed to compensate for the problems developed by preexisting methods. This study was designed to evaluate the effect of the ultrasound-guided transverse abdominis plane block (US-TAP block) and compare efficacy according to the concentration of local analgesics in patients undergoing laparoscopic cholecystectomy.MethodsFifty-four patients undergoing laparoscopic cholecystectomy were randomized into three groups. The patients in Group Control did not receive the US-TAP block. The patients in Group B0.25 and Group B0.5 received the US-TAP block with 0.25% and 0.5% levobupivacaine 30 ml respectively. After the general anesthesia, a bilateral US-TAP block was performed using an in-plane technique with 15 ml levobupivacaine on each side. Intraoperative use of remifentanil and postoperative demand of rescue analgesics in PACU were recorded. The postoperative verbal numerical rating scale (VNRS) was evaluated at 20, 30, and 60 min, and 6, 12, and 24 hr. Postoperative complications, including pneumoperitoneum, bleeding, infection, and sleep disturbance, were also checked.ResultsThe intraoperative use of remifentanil, postoperative VNRS and the postoperative demand of rescue analgesics were lower in the groups receiving the US-TAP block (Group B0.25 and Group B0.5) than Group Control. There were no statistically or clinically significant differences between Group B0.25 and Group B0.5. No complications related to the US-TAP block were observed.ConclusionsThe US-TAP block with 0.25% or 0.5% levobupivacaine 30 ml (15 ml on each side) significantly reduced postoperative pain in patients undergoing laparoscopic cholecystectomy.

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Section: Introductionmentioning

confidence: 99%

The analgesic effect of the ultrasound-guided transverse abdominis plane block after laparoscopic cholecystectomy

Suk

Kim

Lee

et al. 2010

Korean J Anesthesiol

133

138

View full text Add to dashboard Cite

show abstract

“…Regional anesthesia in the form of epidural analgesia has been found to be an effective way of improving pain control after laparoscopic cholecystectomy. 29 However, in liver resections, transient impairment of liver function may occur and possibly increase the risk of epidural hematoma. 1Y6 Therefore, epidural analgesia has been controversial.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Addition of Bupivacaine to Intrathecal Morphine and Fentanyl for Postoperative Pain Management in Laparascopic Liver Resection

Nguyen¹,

Vandenbroucke

Roy³

et al. 2010

Regional Anesthesia and Pain Medicine

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“…Low incidence in their study could be attributed to antiemetic prophylaxis with metoclopramide and ondansetron, avoidance of hypotension, adequate pain control and avoidance of postoperative parenteral opioids medication. Demet et al (19) found that epidural group had a lower incidence of nausea/vomiting and sedation compared with intravenous analgesia.…”

Section: Fmentioning

confidence: 99%

“…Also resting postoperative VAS pain score at discharge was 4.7 ± 2.5 in general anesthesia versus 2.2 ± 1.6 in epidural anesthesia. Demet et al (19) found that mean pain scores in the epidural group (0.16±0.31) were lower than those in the intravenous group (3.13±1.75), and concluded that epidural analgesia with a bupivacaine/fentanyl combination provided a statistically and clinically…”

Section: Ementioning

confidence: 99%

Laparoscopic Cholecystectomy Under Thoracic Epidural Anesthesia in Comparison With General Anesthesia

Durgham

Ahmad

Zakzouk

2014

Zagazig University Medical Journal

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Background: Regional anesthesia for laparoscopic cholecystectomy (LC) is considered to have some advantages compared with general anesthesia. Patients can be awake and oriented at the end of the surgery and have less postoperative pain, nausea and vomiting. Problems related to general anesthesia such as oral and teeth injury during laryngoscopy, and a sore throat and stomach inflation as a result of mask ventilation might be avoided in a regional anesthetic setting. Objective: the aim of the study is to compare between thoracic epidural anesthesia (TEA) and general anesthesia (GA) for LC regarding intraoperative hemodynamics, postoperative analgesia and cost. Patients and methods: 116 patients undergoing elective laparoscopic cholecystectomy surgery in general surgery department in Zagazig University hospitals were randomly divided into two groups. Group A received GA with 1-2 µg/kg fentanyl, 2 mg/kg propofol, 0.5 mg/kg cis-tracrium and isoflurane 2 MAC. Group B received 15 ml bupivacaine 0.5% with 70-100 µg fentanyl in thoracic epidural catheter inserted at T 10-11 interspace. Both groups were given 30 ml bupivacaine 0.375% intraperitoneal infradiaphragmatic after insertion of the trocar and insufflations of the peritoneal cavity before starting surgery. Results: TEA proved to be having lower incidence of postoperative shoulder pain, postoperative nausea and vomiting (PONV) and lower cost than GA and a higher incidence of patient and surgeon satisfaction, hypotension and bradycardia. Conclusion: TEA may be a good alternative to GA for LC.

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Efficacy of thoracic epidural analgesia for laparoscopic cholecystectomy

Abstract: The epidural technique provided a significant effect on postoperative pain in patients undergoing laparoscopic cholecystectomy.

Cited by 34 publications

References 33 publications

The analgesic effect of the ultrasound-guided transverse abdominis plane block after laparoscopic cholecystectomy

The analgesic effect of the ultrasound-guided transverse abdominis plane block after laparoscopic cholecystectomy

Evaluation of the Addition of Bupivacaine to Intrathecal Morphine and Fentanyl for Postoperative Pain Management in Laparascopic Liver Resection

Laparoscopic Cholecystectomy Under Thoracic Epidural Anesthesia in Comparison With General Anesthesia

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