Pain relief from combined wound and intraperitoneal local anesthesia for patients who undergo laparoscopic cholecystectomy.

Chun-Nan Yeh, Chun-Yi Tsai, Chi-Tung Cheng, Shang-Yu Wang, Yu-Yin Liu, Kun-Chun Chiang, Feng-Jen Hsieh, Chih-Chung Lin, Yi-Yin Jan, Miin-Fu Chen
Author Information
  1. Chun-Nan Yeh: Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsing Street, Kwei-Shan, Taoyuan, Taiwan. yehchunnan@gmail.com.

Abstract

BACKGROUND: Laparoscopic cholecystectomy (LC) has become the treatment of choice for gallbladder lesions, but it is not a pain-free procedure. This study explored the pain relief provided by combined wound and intraperitoneal local anesthetic use for patients who are undergoing LC.
METHODS: Two-hundred and twenty consecutive patients undergoing LC were categorized into 1 of the following 4 groups: local wound anesthetic after LC either with an intraperitoneal local anesthetic (W + P) (group 1) or without an intraperitoneal local anesthetic (W + NP) (group 2), or no local wound anesthetic after LC either with intraperitoneal local anesthetic (NW + P) (group 3) or without an intraperitoneal local anesthetic (NW + NP) (group 4). A visual analog scale (VAS) was used to assess postoperative pain. The amount of analgesic used and the duration of hospital stay were also recorded.
RESULTS: The VAS was significantly lower immediately after LC for the W + P group than for the NW + NP group (5 vs. 6; p = 0.012). Patients in the W + P group received a lower total amount of meperidine during their hospital stay. They also had the shortest hospital stay after LC, compared to the patients in the other groups.
CONCLUSION: Combined wound and intraperitoneal local anesthetic use after LC significantly decreased the immediate postoperative pain and may explain the reduced use of meperidine and earlier discharge of patients so treated.

References

  1. J Hepatobiliary Pancreat Sci. 2010 Sep;17(5):637-56 [PMID: 20393755]
  2. World J Surg. 2009 Aug;33(8):1720-6 [PMID: 19440650]
  3. World J Gastroenterol. 2009 May 21;15(19):2376-80 [PMID: 19452582]
  4. Reg Anesth Pain Med. 2011 Mar-Apr;36(2):103-9 [PMID: 21425506]
  5. Middle East J Anaesthesiol. 1999 Feb;15(1):39-62 [PMID: 10068970]
  6. Surg Endosc. 2005 Nov;19(11):1503-6 [PMID: 16328673]
  7. Surg Endosc. 2005 Jul;19(7):915-8 [PMID: 15868265]
  8. Am J Surg. 2011 Mar;201(3):369-72; discussion 372-3 [PMID: 21367381]
  9. Br J Surg. 2000 Mar;87(3):273-84 [PMID: 10718794]
  10. Surg Endosc. 2008 Sep;22(9):2036-45 [PMID: 18270769]
  11. World J Surg. 2009 Sep;33(9):1904-8 [PMID: 19597878]
  12. Anesthesiology. 2006 Apr;104(4):835-46 [PMID: 16571981]
  13. Surg Laparosc Endosc. 1997 Oct;7(5):407-14 [PMID: 9348622]
  14. Anesth Analg. 2006 Sep;103(3):682-8 [PMID: 16931681]
  15. Best Pract Res Clin Anaesthesiol. 2005 Jun;19(2):247-68 [PMID: 15966496]
  16. Br J Surg. 1995 Oct;82(10):1374-7 [PMID: 7489170]
  17. World J Gastroenterol. 2006 Feb 7;12(5):772-5 [PMID: 16521193]
  18. Surg Endosc. 2006 Oct;20(10):1629 [PMID: 16902745]
  19. Surg Endosc. 2002 Nov;16(11):1583-7 [PMID: 12085147]
  20. Br J Surg. 2000 Sep;87(9):1161-5 [PMID: 10971421]
  21. Kathmandu Univ Med J (KUMJ). 2009 Jan- Mar;7(25):50-3 [PMID: 19483453]
  22. Eur J Surg. 1993 Apr;159(4):217-21 [PMID: 8102542]
  23. Surg Laparosc Endosc Percutan Tech. 2009 Jun;19(3):234-40 [PMID: 19542853]
  24. Surg Endosc. 2003 Oct;17(10):1573-8 [PMID: 12964062]
  25. J Laparoendosc Surg. 1992 Apr;2(2):81-6; discussion 87 [PMID: 1350741]
  26. Trop Gastroenterol. 2009 Jul-Sep;30(3):171-4 [PMID: 20306755]
  27. Surg Endosc. 2003 Oct;17(10):1676 [PMID: 14702968]

MeSH Term

Administration, Topical
Adult
Aged
Aged, 80 and over
Amides
Anesthesia, Local
Anesthetics, Local
Cholecystectomy, Laparoscopic
Drug Administration Schedule
Female
Humans
Infusions, Parenteral
Male
Middle Aged
Pain Measurement
Pain, Postoperative
Prospective Studies
Ropivacaine
Treatment Outcome

Chemicals

Amides
Anesthetics, Local
Ropivacaine

Word Cloud

Created with Highcharts 10.0.0localLCanestheticintraperitonealgroupwoundpatientspainuseW + Phospitalstaycholecystectomyreliefcombinedundergoing14eitherwithoutNW + NPVASusedpostoperativeamountalsosignificantlylowermeperidineBACKGROUND:Laparoscopicbecometreatmentchoicegallbladderlesionspain-freeprocedurestudyexploredprovidedMETHODS:Two-hundredtwentyconsecutivecategorizedfollowinggroups:W + NP2NW + P3visualanalogscaleassessanalgesicdurationrecordedRESULTS:immediately5vs6p = 0012PatientsreceivedtotalshortestcomparedgroupsCONCLUSION:CombineddecreasedimmediatemayexplainreducedearlierdischargetreatedPainanesthesiaundergolaparoscopic

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