Ropivacaine preperitoneal wound infusion for pain relief and prevention of incisional hyperalgesia after laparoscopic colorectal surgery: a randomized, triple‐arm, double‐blind controlled evaluation vs intravenous lidocaine infusion, the CATCH study

Abstract

Ropivacaine CWI at the site of the abdominal incision did not provide any significant benefit either on analgesia or on the prevention of wound hyperalgesia after LCR.

The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery

“…After reviewing the full text, 15 additional irrelevant trials were excluded. Finally, the articles considered to be suitable for this meta‐analysis consisted of 10 RCTs, enrolling a total of 527 adult patients. The search process is shown in Figure .…”

“…Of the 10 studies, 2 studies were from Belgium; 2 studies were from Korea; 2 studies were from China; and the each of the remaining 4 studies were from France, Egypt, Lithuania, and Slovenia. All studies received IV lidocaine infusion before skin incision; five studies received IV lidocaine for more than 24 hours after surgery, and the other five studies infused lidocaine less than 24 hours after surgery. Most of the loading dose of lidocaine was 1.0 to 2.0 mg/kg, and continuous dose was 1.0 to 2.0 mg/kg/h.…”

“…The degree of pain was easier to observe on movement than at rest. So, demonstrating any analgesic effect at low levels of pain intensity was difficult . Second, laparoscopic colorectal surgery itself could reduce postoperative pain and opioid consumption compared with open surgery, so the analgesic efficacy of systemic lidocaine may be diminished …”

“…Laparoscopic surgery has gradually replaced traditional laparotomy because it has many advantages, such as less bleeding, faster recovery, and fewer complications . Nevertheless, the abdominal incision for the extraction of the specimen is a trigger for wound pain after laparoscopic colorectal surgery . Evidence showed that this painful sensation could be severe and persistent during the postoperative period, and complications from insufficient pain treatment are associated with a range of problems, such as extended hospital stay, readmissions, and dissatisfaction of patients .…”

“…Nevertheless, the abdominal incision for the extraction of the specimen is a trigger for wound pain after laparoscopic colorectal surgery . Evidence showed that this painful sensation could be severe and persistent during the postoperative period, and complications from insufficient pain treatment are associated with a range of problems, such as extended hospital stay, readmissions, and dissatisfaction of patients . Thus, the effective management of postoperative pain after laparoscopic colorectal surgery should not be neglected.…”