Pre-emptive intraperitoneal local anaesthesia: an effective method in immediate post-operative pain management and metabolic stress response in laparoscopic appendicectomy, a randomized, double-blinded, placebo-controlled study

Abstract

Pre-emptive intraperitoneal local anaesthesia in laparoscopy surgery is a safe, non-invasive procedure that can benefit patients by reducing the immediate post-operative pain intensity and metabolic stress response of the body.

The role of intraperitoneal ropivacaine in laparoscopic appendicectomy: a prospective, double‐blinded randomized control Australian study

“…Our study has confirmed the early analgesic effects of intraperitoneal local ropivacaine in laparoscopic appendicectomy in an Australian population during the first 6‐h post operation. Similar outcomes have been reported by two overseas studies . Other intraperitoneal agents such as tramadol, bupivacaine and lornoxicam with positive analgesic post‐operative effects have been reported in similar randomized controlled studies …”

“…We found that patients used PCA 33% times more often in the placebo group compared to the ropivacaine group, which resulted in a 28% increase in the fentanyl per kilogram usage within the first 6 h. However, the analgesic effect of the intraperitoneal local anaesthetic was seen to taper off after the initial 6 h. The reduction in additional analgesia used from the intraperitoneal group was not as significant and prolonged as suggested by Thanapel et al . This difference may be multifactorial.…”

“…This difference may be multifactorial. Firstly, the local intraperitoneal local in the Thanapel et al . group was injected at the start of the operation as compared to our study which the local anaesthetic was injected at the end of the operation.…”

“…Although its use has been widely studied in laparoscopic hernia repairs, gynaecological laparoscopy and laparoscopic cholecystectomies, no Australian study investigating its role in laparoscopic appendicectomy has been published. There is some recent evidence from overseas studies from Malaysia and Korea to suggest ropivacaine is safe and works well as an analgesic agent when given intraperitoneally, while others have used other agents such as lornoxicam, bupivacaine and tramadol instead of ropivacaine . The aim of this study was to determine whether the use of intraperitoneal ropivacaine during laparoscopic appendicectomy will reduce the amount of post‐operative opiate analgesia used, abdominal pain, post‐operative nausea or vomiting, shoulder tip pain and length of hospital stay.…”

Investigation of Effects of Epidural Anaesthesia Combined with General Anaesthesia on the Stress Response in Patients Undergoing Hip and Knee Arthroplasty

“…Anestezi yöntemleri de cerrahiye stres yanıtı modifiye etmek için kullanılır (7). Birçok ameliyat türünde farklı anestezi ajanları ve yöntemleri ile cerrahiye karşı oluşan stres yanıtın incelenmesi halen çe-şitli araştırmalara konu olmaktadır (8)(9)(10)(11). Bu araştırmaların çoğu abdominal cerrahi ile ilgilidir; oluşan stres yanıt cerrahinin niteliği ile de ilişkili olduğundan, anestezi yöntemleri-nin farklı cerrahi türlerinde stres yanıta etkisi araştırılmalıdır (7,11,12).…”