Post-Laparoscopic Cholecystectomy Pain: Effects of Preincisional Infiltration and Intraperitoneal Levobupivacaine 0.25% on Pain Control-a Randomized Prospective Double-Blinded Placebo-Controlled Trial

Karaman, Yücel; Görgün, Mehmet; Güvenli, Yalçın; Tekgül, Zeki Tuncel

doi:10.5152/tjar.2014.06025

Cited by 11 publications

(9 citation statements)

References 19 publications

(8 reference statements)

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“…who reported the analgesic effects of intraperitoneal levobupivacaine for laparoscopic cholecystectomy and found that it is an effective method for decreasing pain after laparoscopic cholecystectomy and reducing antiemetic drug taking. [ 20 ]…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal levobupivacaine alone or with dexmedetomidine for postoperative analgesia after laparoscopic cholecystectomy

Baz

Farahat

2018

Anesth Essays Res

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Background and Aims:Local anesthetic injection in the peritoneal cavity decreases intensity of postoperative pain after laparoscopic surgeries. We compared adding dexmedetomidine to intraperitoneal levobupivacaine in patients undergoing laparoscopic cholecystectomy.Methods:A total of 105 patients were included in this prospective, double-blinded, randomized study. Patients were randomly divided into three equal sized (n = 35) study groups. Group C patients received intraperitoneal 40 ml normal saline as controlled group. Group L was given 40 ml 0.25% levobupivacaine. Group LD received 40 ml 0.25% levobupivacaine + dexmedetomidine 1 μg/kg. The degree of postoperative pain was measured by visual analog scale (VAS) score. The time of first analgesic demand was recorded and also total dose of painkiller in the first 24 h and postoperative complications were collected. SPSS version 16 was used for statistical analysis. P < 0.05 was considered statistically significant.Results:Postoperative VAS at different time intervals was significantly lower, time to the first demand of painkiller (min) was longer (30.2 ± 14.4, 45.9 ± 20.1, and 56.5 ± 13.2), and total painkiller consumption (mg) was lower (203.5 ± 42.9, 117.8 ± 63.7, and 46.3 ± 41.3) in Group LD than Group L than Group C.Conclusion:Adding dexmedetomidine to intraperitoneal levobupivacaine is superior to and gives better results than levobupivacaine alone in patients undergoing laparoscopic cholecystectomy.

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Section: Discussionmentioning

confidence: 99%

Intraperitoneal levobupivacaine alone or with dexmedetomidine for postoperative analgesia after laparoscopic cholecystectomy

Baz

Farahat

2018

Anesth Essays Res

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“…compared the effects of the combination of preincision infiltration of trocar sites plus intraperitoneal instillation of levobupivacaine 0.25% after pneumoperitoneum with intraperitoneal instillation alone for postoperative pain management following laparoscopic cholecystectomy and found that either the combination or intraperitoneal instillation of LA alone reduced the shoulder pain significantly than the control group. [ 8 ] Similarly, Louizos et al . also observed that this combination was better than other groups as well as the control group.…”

Section: Discussionmentioning

confidence: 99%

“…A few studies have analyzed the efficacy of combined trocar site infiltration and intraperitoneal instillation of LA and the results are conflicting. [ 8 9 10 ] Karaman et al . compared the effects of the combination of preincision infiltration of trocar sites plus intraperitoneal instillation of levobupivacaine 0.25% after pneumoperitoneum with intraperitoneal instillation alone for postoperative pain management following laparoscopic cholecystectomy and found that either the combination or intraperitoneal instillation of LA alone reduced the shoulder pain significantly than the control group.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have tested the efficacy of trocar site infiltration, intraperitoneal instillation of LA for visceral and shoulder pain,[ 2 3 4 5 6 7 ] while only a few studies investigated the combination of preincisional subcutaneous infiltration (at trocar sites) and intraperitoneal instillation of LA. [ 8 9 10 ] Hence, this study was designed to compare this particular combination with trocar site infiltration alone for pain relief after laparoscopic procedures more particularly STP.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of trocar site versus trocar site plus intraperitoneal instillation of local anesthetic for shoulder pain following laparoscopic abdominal surgery

et al. 2021

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Background: Laparoscopic surgery in recent times has noteworthy advantages over conventional surgery, yet recovery is prolonged due to debilitating shoulder tip pain (STP) and operated site pain. Various studies have compared the effect of trocar site, intraperitoneal instillation of local anesthetic (LA) for pain relief while only a few studies have tested the combination of these two techniques. Hence, this study was undertaken to compare the combination of these two techniques versus trocar site alone for STP particularly. Subjects and Methods: This prospective, randomized, comparative study was conducted on 52 patients who were undergoing laparoscopic abdominal surgery. The patients were allocated into either of the two groups. Group I ( n = 26): trocar site infiltration (20 mL) and intraperitoneal instillation (20 mL) of 0.25% levobupivacaine and Group II ( n = 26): trocar site infiltration (20 mL) of 0.25% levobupivacaine and saline (20 mL) intraperitoneally. Postoperative STP was the primary outcome while surgical site pain, nausea, and vomiting were secondary outcomes. Results: There were no statistically significant differences between the groups with regard to shoulder pain, surgical site pain, total rescue analgesics, and incidence of nausea and vomiting ( P > 0.05). Conclusion: Trocar site infiltration with intraperitoneal instillation of LA or trocar site infiltration alone was found to be equally effective. However, we suggest that it is better to provide a combination of trocar site infiltration plus intraperitoneal instillation of LA if we have to restrict opioid usage such as in day-care surgeries.

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“…[ 10 ] There are some studies that propose that preincisional analgesic infiltration can delay the first analgesic requirement in the postoperative period. [ 11 12 ] With this background the present study was carried out with an aim to evaluate and compare the postoperative pain relief in AH patient under general anesthesia after preincisional versus postincisional infiltration of surgical area with Bupivacaine. The dose selection of Bupivacaine was done keeping in view the previous studies that have reported up to 50 mL of 0.25% to 0.375% Bupivacaine infused subcutaneously to be safe and effective in the management of postoperative pain in AH or other major abdominal surgery cases.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of postoperative pain relief using preincisional versus postincisional infiltration with 0.25% bupivacaine in abdominal hysterectomy under general anesthesia

et al. 2021

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Background and Aims: Hysterectomy, probably the most common non-pregnancy related surgery performed in gynaecology, is associated with moderate to severe post-operative pain. Wound infiltration with local anaesthetic agent reduces the transmission of pain from the wound, in addition, local inflammatory response to the injury is also suppressed. The infiltration of local anaesthesia can be done either pre- or post-operatively. The present study was designed to determine the efficacy of pre-incisional infiltration versus post-incisional infiltration with 0.25% Bupivacaine in providing post-operative pain relief in patients undergoing abdominal hysterectomy. Methods: In Prospective Interventional Randomised study, 90 female patients posted for elective abdominal hysterectomy under general anaesthesia were randomly allocated into three equal groups of 30 patients each. Group I: Patients receiving subcutaneous infiltration with 40 mL of 0.25% Bupivacaine 5 mins before skin incision. Group II: Patients receiving subcutaneous infiltration of surgical area with 40 mL of 0.25% Bupivacaine at end of surgery (after peritoneal closure). Group III (Control Group): Patients receiving no local anaesthetic infiltration. Observations were made for the duration of effective analgesia from end of the surgery until the first use of rescue analgesic along with the frequency and cumulative amount of rescue analgesics in 24 hours. Results: We found that at baseline, pain score of patients in Group III (3.87±1.17) was maximum followed by that in Group I (2.57±0.90) and minimum in Group II (2.20±0.61). Requirement of first analgesia was earliest in Group III (79.50±23.90 minutes) followed by Group I (136.83±13.16 minutes) and last in Group II (146.17±12.78 minutes), in addition, cumulative dose of analgesia was required by patients in Group III (152.50±36.76 mg) followed by that in Group I (132.50±37.80 mg) and minimum by that in Group II (115.00±38.06 mg). Conclusion: Subcutaneous infiltration of Bupivacaine either pre-incisional or post-incisional, helped to reduce the immediate post-operative pain intensity, delayed the first rescue analgesic requirement, reduced the post-operative dose and frequency of rescue analgesia. However, post-incisional intervention had an edge over pre-incisional intervention.

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Post-Laparoscopic Cholecystectomy Pain: Effects of Preincisional Infiltration and Intraperitoneal Levobupivacaine 0.25% on Pain Control-a Randomized Prospective Double-Blinded Placebo-Controlled Trial

Cited by 11 publications

References 19 publications

Intraperitoneal levobupivacaine alone or with dexmedetomidine for postoperative analgesia after laparoscopic cholecystectomy

Intraperitoneal levobupivacaine alone or with dexmedetomidine for postoperative analgesia after laparoscopic cholecystectomy

Comparison of trocar site versus trocar site plus intraperitoneal instillation of local anesthetic for shoulder pain following laparoscopic abdominal surgery

Comparative study of postoperative pain relief using preincisional versus postincisional infiltration with 0.25% bupivacaine in abdominal hysterectomy under general anesthesia

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