Randomized clinical trial of the influence of intraperitoneal local anaesthesia on pain after laparoscopic surgery

Abstract

Pre-emptive application of LA reduced postoperative pain and analgesic requirements after laparoscopic fundoplication.

Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery

“…The data reported in our study do not match the results of several randomized controlled trials which assessed use of intraperitoneal local anesthetic administration in the setting of simpler laparoscopic procedures, such as laparoscopic cholecystectomy, inguinal hernia repair, and fundoplication [9,10,19]. In this context, the extent of surgical trauma, the timing and type of local anesthetic administered, as well as the route of administration are likely to play an important role.…”

“…Based on prior reports [10] and on our personal experience, we estimated the average VAS for laparoscopic colorectal resections on postoperative day 1 to be 4.5, with standard deviation of 1. A reduction of VAS of 1 unit was deemed clinically relevant [9,18].…”

“…Use of local anesthesia has been advocated as a means to further reduce postoperative pain and consumption of opioids, thereby reducing the potential for adverse effects related to opioids, while improving patient recovery and potentially reducing hospital length of stay [7][8][9]. The route of administration of local anesthetic varies, with the subcutaneous and intraperitoneal routes being most frequently used [7,9,10]. However, there is wide heterogeneity in clinical practice, with no strong evidence in favor of either route of administration [11].…”

Evaluation of postoperative pain relief with intra-peritoneal bupivacaine instillation in laparoscopic cholecystectomy- a randomized control study

“…24,25 The effect of pre-emptive and post-operative application of local anaesthetics in laparoscopic surgery was studied and concluded that pre-emptive application of local anaesthetics reduces the post-operative pain and analgesic requirements after laparoscopic fundoplication better than laparoscopic herniorraphy. 26 There are a few other studies in which local anaesthetic instillation has failed to show the efficacy. These failures were could be because of use of lower dosage, lower concentration or because the entire dose was instilled under right hemidiaphragm.…”

Intraperitoneal and intravenous lidocaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study

“…Because the proposed cause of shoulder tip pain in laparoscopic procedures is diaphragmatic stretching with phrenic nerve neuropraxia [23,37], it is not strange that intraperitoneal instillation of local anesthetic has been shown to effectively reduce shoulder tip pain. The effect of intravenous lidocaine on shoulder tip pain was previously not known.…”