Preemptive Analgesia: Intraperitoneal Local Anesthetic in Laparoscopic Cholecystectomy

Pasqualucci, Alberto; Angelis, Vincent De; Contardo, R; Colò, Francesca; Terrosu, Giovanni; Donini, Annibale; Pasetto, Alberto; Bresadola, F

doi:10.1097/00000542-199607000-00003

Cited by 199 publications

(70 citation statements)

References 33 publications

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“…Similar findings were also reported in other studies [11][12][13][14] The findings of the present study reveal that intraperitoneal ropivacaine administered after surgery pre-empts postoperative pain relative to an untreated placebo controlled group. This is similar to the study by Pasqualucci A et al (1996) [15]. Kucuk et al (2007) [16] compared the effect of intraperitoneal ropivacaine (150 mg) in patients undergoing a laparoscopic cholecystectomy.…”

Section: Discussionsupporting

confidence: 83%

The Effect of Intraperitoneal Ropivacaine for Post-Operative Pain Management in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective Double-Blind Randomized Control Study

Singh¹,

Bogra²,

Saxena³

et al. 2013

OJAnes

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Objective: To compare the effect of intraperitoneal ropivacaine with placebo for post-operative pain management in patients undergoing laparoscopic cholecystectomy. Material and Methods: All patients were pre-medicated with glycopyrrolate 0.2 mg, ondansetron 4 mg and ranitidine 150 mg intravenously half an hour prior to induction of anesthesia. All patients were given standard general anaesthesia with propofol (2-2.5 mg/kg), fentanyl 2 μg/kg, and succinylcholine (2 mg/kg) to facilitate tracheal intubation. Anesthesia was maintained with 60% N₂O in oxygen with 0.5% to 1% Halothane. Group A: Patients received 20 ml of 0.9% normal saline as placebo (n = 25). Group B: Patients received 20 ml of 0.5% ropivacaine (n = 25). Results: The age and sex distribution of both the groups was similar. The heart rate, systolic & diastolic blood pressure, mean blood pressure and mean trend of SpO₂ in both groups remained similar over the periods. The mean VAS varied considerably within (between time) and between the groups (treatment) and was especially comparatively higher in Group A at initial hours 15 min to 30 min and at end hours 12-24 hrs as compared with Group B. On an average, the frequent dosing of rescue analgesia and mean No. of rescue analgesia ...

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Section: Discussionsupporting

confidence: 83%

The Effect of Intraperitoneal Ropivacaine for Post-Operative Pain Management in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective Double-Blind Randomized Control Study

Singh¹,

Bogra²,

Saxena³

et al. 2013

OJAnes

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“…Nevertheless, the reason for the inconsistent analgesic outcome with use of intraperitoneal bupivacaine following laparoscopic surgery is not obvious. One possible explanation is differences related to administration technique, since studies in patients undergoing laparoscopic inguinal hernia repair have shown that the timing of the instillation can influence its effectiveness 31,32. In another authoritative review of surgical wound infiltration, the importance of using controlled and meticulous techniques has been strongly emphasized 39.…”

Section: Discussionmentioning

confidence: 99%

A feasibility study to investigate the use of a bupivacaine-collagen implant (XaraColl) for postoperative analgesia following laparoscopic surgery

Hemsen¹,

Cusack²,

Minkowitz³

et al. 2013

JPR

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BackgroundXaraColl, a collagen-based implant that delivers bupivacaine to sites of surgical trauma, has been shown to reduce postoperative pain and use of opioid analgesia in patients undergoing open surgery. We therefore designed and conducted a preliminary feasibility study to investigate its application and ease of use for laparoscopic surgery.MethodsWe implanted four XaraColl implants each containing 50 mg of bupivacaine hydrochloride (200 mg total dose) in ten men undergoing laparoscopic inguinal or umbilical hernioplasty. Postoperative pain intensity and use of opioid analgesia were recorded through 72 hours for comparison with previously reported data from efficacy studies performed in men undergoing open inguinal hernioplasty. Safety was assessed for 30 days.ResultsXaraColl was easily and safely implanted via a laparoscope. The summed pain intensity and total use of opioid analgesia through the first 24 hours were similar to the values observed in previously reported studies for XaraColl-treated patients after open surgery, but were lower through 48 and 72 hours.ConclusionXaraColl is suitable for use in laparoscopic surgery and may provide postoperative analgesia in laparoscopic patients who often experience considerable postoperative pain in the first 24–48 hours following hospital discharge. Randomized controlled trials specifically to evaluate its efficacy in this application are warranted.

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“…Also Pasqualucci et al [5] stated that in cholecystectomy by laparoscopy, the administration of 0.5% bupivacaine 20 ml in the peritoneal space for visceral pain prevention against stimulation of the diaphragm by carbon dioxide and surgical manipulation was effective in pain alleviation for the first day after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Many attempt at post-operative pain control following a laparoscopic cholecystectomy exist. The infiltration of local anesthetic at the trocar insertion site, into the intraperitoneal space or blood vessel by direct local anesthetic administration are effective for postoperative pain reduction [3-5]. Also the ultrasound-guided transverse abdominis plane block (TAPB) is reported to be safe to perform and to reduce perioperative and postoperative pain and reduce the dosage of opioid analgesics [6,7].…”

Section: Introductionmentioning

confidence: 99%

The analgesic effect of ultrasound-guided transverse abdominis plane block after laparoscopic totally extraperitoneal hernia repair

Kim

et al. 2012

Korean J Anesthesiol

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BackgroundThe ultrasound-guided transverse abdominis plane block (TAPB) reduces postoperative pain after laparoscopic abdominal surgery. But, its effect post laparoscopic totally extraperitoneal hernia repair (TEP) is not clear. In this study, we evaluated the analgesic effect of ultrasound-guided TAPB in TEP.MethodsIn this prospective, randomized study, forty adult patients (ASA I-II) scheduled for a TEP under general anesthesia were studied. In the TAPB group (n = 20), an ultrasound-guided bilateral TAPB was performed with 0.375% ropivacaine 15 ml on each side after the induction of general anesthesia. The control group (n = 20) did not have TAPB performed. Fentanyl 50 µg was repeatedly injected as per the patient's request in the recovery room. Pain scores at rest and on coughing were assessed postoperatively in the recovery room (20 min, at discharge) and at 4, 8, and 24 hours after surgery.ResultsIn the recovery room, pain scores (numeric rating scale, 0-10) at postoperative 20 min were lower in the TAPB group (3.9 ± 1.6, 4.9 ± 1.8) than the control group (6.9 ± 1.6, 8.0 ± 1.6) at rest and on coughing. Also, pain scores upon discharge from the recovery room were lower in the TAPB group (3.2 ± 1.2, 4.2 ± 1.5) than the control group (5.3 ± 1.6, 6.5 ± 1.8) at rest and on coughing.ConclusionsThe ultrasound-guided TAPB in patients that had undergone TEP reduced postoperative pain scores and the fentanyl requirement in the recovery room. Also, pain scores on coughing were reduced until postoperative 8 hours.

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Preemptive Analgesia: Intraperitoneal Local Anesthetic in Laparoscopic Cholecystectomy

Cited by 199 publications

References 33 publications

The Effect of Intraperitoneal Ropivacaine for Post-Operative Pain Management in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective Double-Blind Randomized Control Study

The Effect of Intraperitoneal Ropivacaine for Post-Operative Pain Management in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective Double-Blind Randomized Control Study

A feasibility study to investigate the use of a bupivacaine-collagen implant (XaraColl) for postoperative analgesia following laparoscopic surgery

The analgesic effect of ultrasound-guided transverse abdominis plane block after laparoscopic totally extraperitoneal hernia repair

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