Postoperative pain relief after laparoscopic cholecystectomy: A placebo-controlled double-blind randomized trial of preincisional infiltration and intraperitoneal instillation of levobupivacaine 0.25%

Louizos, A.; Hadzilia, S.; Leandros, Emmanuel; Kouroukli, I.; Georgiou, L.; Bramis, J.

doi:10.1007/s00464-005-3002-4

Cited by 92 publications

(81 citation statements)

References 19 publications

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“…It occurs after diaphragmatic stretching with phrenic nerve neuropraxia. The incidence of shoulder pain is markedly lower in laparoscopic hysterectomy when compared to laparoscopic cholecystectomy [25]. In our study, shoulder tip pain was observed only in 2 patients in group R and none in group RD.…”

Section: Discussionmentioning

confidence: 55%

Postoperative Analgesia With Intraperitoneal Ropivacaine With and Without Dexmedetomidine After Total Laparoscopic Hysterectomy: A Randomized, Double-Blind, Controlled Trial

Acharya

Karan²,

Khetan³

2016

Asian J Pharm Clin Res

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Objective: In this advanced era of surgery, laparoscopic hysterectomy operations are very commonly practiced by surgeons. It reduces trauma, morbidity, and health-care costs, ensuring early discharge. However, the early post-operative pain experienced by patients may sometimes negate all the advantages of a laparoscopic procedure. Intraperitoneal (IP) instillation of local anesthetics has been proposed to decrease post-operative pain after laparoscopic surgeries. Additives to local anesthetics like α-2 agonists such as clonidine and dexmedetomidine prolong the duration of analgesia. Therefore, this randomized, prospective, controlled study was conducted to compare the analgesic efficacy of IP ropivacaine with or without dexmedetomidine for postoperative analgesia after total laparoscopy hysterectomy. Methods:At the end of laparoscopic hysterectomy, in a double-blind, randomized manner, one of the following injections was given intraperitoneally. The patients were allocated into the following two groups: The patients in ropivacaine group (R group) (N = 40) were given 38 ml of 0.2% ropivacaine plus 2 ml of normal saline (NS) and the patients in ropivacaine plus dexmedetomidine group (RD group) (N = 40) were given 38 ml of 0.2% ropivacaine combined with 0.5 µg/kg dexmedetomidine (diluted in 2 ml NS) through trocars. All the patients were given diclofenac sodium when they had a pain score of 4 on visual analog scale (VAS).Results: VAS score at different time intervals was significantly lower after the second postoperative hour, time to first request of analgesia (minutes) was longest (487.7±40.96 vs. 242.5±19.84), and the total analgesic consumption (mg) was lowest (61.88±37.55 vs. 183.75±44.78) in RD group than in R group. Conclusion:The antinociceptive effects of the IP instillation of ropivacaine in combination with dexmedetomidine are superior to ropivacaine alone in laparoscopic hysterectomy cases.

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Section: Discussionmentioning

confidence: 55%

Postoperative Analgesia With Intraperitoneal Ropivacaine With and Without Dexmedetomidine After Total Laparoscopic Hysterectomy: A Randomized, Double-Blind, Controlled Trial

Acharya

Karan²,

Khetan³

2016

Asian J Pharm Clin Res

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“…[53] It occurs after diaphragmatic stretching with phrenic nerve neuropraxia and reported after laparoscopic cholecystectomy is markedly lower than that reported after gynecologic laparoscopy. [53][54][55] We found a low incidence of shoulder pain in all treatment groups, because the residual intraperitoneal CO 2 was carefully removed by the surgeon.…”

Section: Discussionmentioning

confidence: 99%

Comparison Of Analgesic Effects Of Intraperitoneal Lornoxicam And Ropivacaine Administration In Laparoscopic Cholecystectomy.

Memedov¹,

Menteş²,

Şimşek³

et al. 2008

TUTFD

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Objectives:In this randomized prospective study, we investigated the effects of lornoxicam vs. ropivacaine for the management of postoperative pain in patients undergoing elective laparoscopic cholecystectomy. Patients and Methods:Patients were randomized into three groups and received 150 mg (80 mL) ropivacaine or 16 mg lornoxicam (80 mL) or placebo (80 mL saline) via multi-regional intraperitoneal instillation and port sites infiltration. Patient-controlled analgesia (PCA) device was used. Tramadol 50 mg tolerable dose, 5 mg/hour basal infusion, bolus dose 20 mg, locked 30 min, 4 hour limit were applied as 200 mg. Postoperative pain was assessed with 100-mm visual analog scale (VAS) at rest, while coughing, and during mobilization. Pain scores were recorded in the post-anesthesia care unit, and at 2, 4, 8, 12,18 and 24 h after the surgery. Results:At 24 h, VAS scores at rest and while coughing were found significantly lower in ropivacaine and lornoxicam group when compared with control group (p=0.047). The percentage of patients needing tramadol was significantly lower with ropivacaine and lornoxicam compared with control (p<0.001, p=0.018). There was no statistically significant difference between ropivacaine and lornoxicam group.Conclusion: Multi-regional, intraperitoneal instillation and port site infiltration of ropivacaine and lornoxicam during laparoscopic cholecystectomy reduces the postoperative pain.Key words: Laparoscopic cholecystectomy; ropivacaine; lornoxicam; postoperative pain.Amaç: Prospektif randomize olarak yapılan bu çalış-mada laparoskopik kolesistektomi sonrası ağrı tedavisinde lornoksikam ve ropivakainin etkisi araştırıl-mıştır. Hastalar ve Yöntemler:Çalışmaya dahil edilen 45 hasta üç gruba randomize edildi. Hastalara 150 mg (80 mL) ropivakain, 16 mg lornoksikam (80 mL) ve plasebo (80 mL saline) intraperitoneal olarak püskürtüldü ve port böl-gelerine infiltre edildi. Ameliyat bitiminde hasta kontrollü analjezi cihazı ile tramadol 50 mg yükleme dozu, 5 mg bazal infüzyon, bolus doz 20 mg, kilitli kalma süresi 30 dk, 4 saatlik limit 200 mg olarak planlandı. Hastaların ağrısı görsel analog skala (VAS) ile 0-100 olacak şekilde istirahat, öksürük sonrası ve mobilizasyon sırasında değerlen-dirildi. Ağrı skorları ilk saatte anestezi derlenme odasında ve 2., 4., 8., 12., 18., 24. saatlerde serviste değerlendirildi. Bulgular:Ropivakain ve lornoksikam grubunda istirahat ve öksürük sonrası VAS değerleri kontrol grubuna göre daha düşük bulundu (p=0.047). Tramadol tüketimi açısından, ropivakain ve lornoksikam grupları arasın-da fark bulunmazken (p>0.05), kontrol grubuna göre bu iki grupta anlamlı düşük olarak bulundu (p<0.001, p=0.018). Ropivakain ve lornoksikam grubu arasında ise istatistiksel olarak anlamlı fark bulunmadı.Sonuç: Ropivakain ve lornoksikamın port bölgelerine, intraperitoneal çoklu bölgeye laparoskopik kolesistektomi sonrası infiltrasyonu ameliyat sonrası ağrı tedavisinde etkin olarak bulunmuştur.Anahtar sözcükler: Laparoskopik kolesistektomi; ropivakain; lornoksikam; ameliyat sonrası a...

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“…Local anesthetic or NSAID infiltration as a part of multimodal analgesia is performed to decrease the pain after surgery. Incision-site local anesthetic infiltration has been found to be effective for the management of postoperative pain, especially in radical prostatectomy and laparoscopic cholecystectomy (18,19). However, our literature search did not reveal any study related to the effect of wound infiltration with lornoxicam alone in thyroid surgery.…”

Section: Discussionmentioning

confidence: 77%

Efficacy of wound infiltration with lornoxicam for postoperative analgesiafollowing thyroidectomy: a prospective, randomized, double-blind study

Kılbaş¹,

Mentes²,

Harlak³

et al. 2015

Turk J Med Sci

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Background/aim: Postoperative pain control constitutes a major problem and studies have focused on reducing opioid requirements using regional techniques. We aimed to investigate the efficacy of wound infiltration with lornoxicam on postoperative pain control following thyroidectomy. Materials and methods:In this prospective, randomized-controlled study, 80 patients scheduled for thyroidectomy were randomly assigned to 2 groups. After the thyroidectomy was performed, patients in group I underwent wound infiltration with 4 mg of lornoxicam and patients in group II received the same amount of saline. Rescue analgesia was provided with additional doses of lornoxicam delivered by an on-demand patient-controlled analgesia device. Total analgesic consumption during the postoperative 24 h, and pain intensities assessed using a visual analog scale score at 0, 2, 4, 8, 12 and 24 h postoperatively were recorded.Results: Pain scores during the postoperative 24 h were slightly lower in group I than in group II, but the difference was not significant (P > 0.05). The mean analgesic consumption was 8.87 ± 1.87 mg and 10.33 ± 1.25 mg in groups I and II, respectively (P > 0.05). Conclusion:Wound infiltration with lornoxicam neither improved postoperative pain control nor decreased total analgesic consumption.

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Postoperative pain relief after laparoscopic cholecystectomy: A placebo-controlled double-blind randomized trial of preincisional infiltration and intraperitoneal instillation of levobupivacaine 0.25%

Abstract: The combination of preincisional local infiltration and intraperitoneal instillation of L-B 0.25% shows an advantage for postoperative analgesia after laparoscopic cholecystectomy.

Cited by 92 publications

References 19 publications

Postoperative Analgesia With Intraperitoneal Ropivacaine With and Without Dexmedetomidine After Total Laparoscopic Hysterectomy: A Randomized, Double-Blind, Controlled Trial

Postoperative Analgesia With Intraperitoneal Ropivacaine With and Without Dexmedetomidine After Total Laparoscopic Hysterectomy: A Randomized, Double-Blind, Controlled Trial

Comparison Of Analgesic Effects Of Intraperitoneal Lornoxicam And Ropivacaine Administration In Laparoscopic Cholecystectomy.

Efficacy of wound infiltration with lornoxicam for postoperative analgesiafollowing thyroidectomy: a prospective, randomized, double-blind study

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