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Local Anesthesia Use for Laparoscopic Cholecystectomy

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Abstract

This study aimed to investigate the effects and timing of local anesthesia during laparoscopic surgery in terms of postoperative pain, nausea, and the need for opioids and antiemetics. This prospective study was carried out on 142 patients who underwent laparoscopic cholecystectomy. Peroperative local anesthesia was not administered to 53 patients (group A). The skin, subcutis, fascia, and parietal peritoneum were infiltrated with 0.5% bupivacaine HCl at trocar sites before trocar insertion in 46 patients (group B). Local anesthesia was given to 43 patients in equal doses at the same sites and the same manner at the end of surgery (group C). The higher requirement for analgesics in group A patients was statistically significant when compared with that in group B and C patients. The mean doses of analgesics postoperatively were significantly higher in group B than in group C. The time delay to the first antiemetics was significantly shorter in group A than in group C. Applying local anesthesia to the skin, subcutis, fascia, and parietal peritoneum through trocar sites reduces the postoperative analgesic requirement and pain intensity. This approach is more effective when applied at the end of an operation than at the start.

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References

  1. JB McKernan JK Champion (1995) ArticleTitleAccess techniques: Veress needle—initial blind trocar insertion versus open laparoscopy with the Hasson trocar Endosc. Surg. Allied Technol. 3 35 Occurrence Handle1:STN:280:ByqB2sjht1U%3D Occurrence Handle7757437

    CAS  PubMed  Google Scholar 

  2. RV Ballem J Rudomanski (1993) ArticleTitleTechniques of pneumoperitoneum Surg. Laparosc. Endosc. 3 42 Occurrence Handle1:STN:280:ByuD1c%2FlvVc%3D Occurrence Handle8258070

    CAS  PubMed  Google Scholar 

  3. JI Alexander (1997) ArticleTitlePain after laparoscopy Br. J. Anaesth. 79 369 Occurrence Handle1:STN:280:DyaK1c%2FltFaqtQ%3D%3D Occurrence Handle9389858

    CAS  PubMed  Google Scholar 

  4. BM Rademaker CJ Kalkman JA Odoom et al. (1994) ArticleTitleIntraperitoneal local anaesthetics after laparoscopic cholecystectomy: effects on postoperative pain, metabolic responses and lung function Br. J. Anaesth. 72 263 Occurrence Handle1:STN:280:ByuC2snjtVE%3D Occurrence Handle8130042

    CAS  PubMed  Google Scholar 

  5. IO Lee SH Kim MH Kong et al. (2001) ArticleTitlePain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine Can. J. Anaesth. 48 545 Occurrence Handle1:STN:280:DC%2BD38%2FhvVygug%3D%3D Occurrence Handle11444448

    CAS  PubMed  Google Scholar 

  6. DJ Alexander SS Ngoi L Lee et al. (1996) ArticleTitleRandomized trial of periportal peritoneal bupivacaine for pain relief after laparoscopic cholecystectomy Br. J. Surg. 83 1223 Occurrence Handle10.1046/j.1365-2168.1996.02336.x Occurrence Handle1:STN:280:ByiC3crktlc%3D Occurrence Handle8983611

    Article  CAS  PubMed  Google Scholar 

  7. T Bisgaard B Klarskov VB Kristiansen et al. (1999) ArticleTitleMulti-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study Anesth. Analg. 89 1017 Occurrence Handle1:STN:280:DyaK1MvktVygtg%3D%3D Occurrence Handle10512282

    CAS  PubMed  Google Scholar 

  8. T Chundrigar R Morris AR Hedges et al. (1993) ArticleTitleIntraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy Ann. R. Coll. Surg. Engl. 75 437 Occurrence Handle1:STN:280:ByuC3MzlsVE%3D Occurrence Handle8285548

    CAS  PubMed  Google Scholar 

  9. ADN Scott AC Greville L McMillan et al. (1992) ArticleTitleLaparoscopic laser cholecystectomy: results of the technique in 210 patients Ann. R. Coll. Surg. Engl. 74 237 Occurrence Handle1:STN:280:ByyD3sjgslY%3D Occurrence Handle1416672

    CAS  PubMed  Google Scholar 

  10. McC Lord (1992) ArticleTitleLaparoscopic cholecystectomy Ann. R. Coll. Surg. Engl. 74 231 Occurrence Handle1416669

    PubMed  Google Scholar 

  11. BI Rees HR Williams (1992) ArticleTitleLaparoscopic cholecystectomy: the first 155 patients Ann. R. Coll. Surg. Engl. 74 233 Occurrence Handle1:STN:280:ByyD3sjgslU%3D Occurrence Handle1416671

    CAS  PubMed  Google Scholar 

  12. TR Gadacz (2000) ArticleTitleUpdate on laparoscopic cholecystectomy, including a clinical pathway Surg. Clin. North Am. 80 1127 Occurrence Handle1:STN:280:DC%2BD3cvmtVOjug%3D%3D Occurrence Handle10987028

    CAS  PubMed  Google Scholar 

  13. A Coda M Bossotti F Feri et al. (2000) ArticleTitleIncisional hernia and fascial defect following laparoscopic surgery Surg. Laparosc. Endosc. Percutan. Tech. 10 34 Occurrence Handle10.1097/00019509-200002000-00008 Occurrence Handle1:STN:280:DC%2BD3cvpsVCkug%3D%3D Occurrence Handle10872524

    Article  CAS  PubMed  Google Scholar 

  14. C Motamed H Bouaziz D Franco et al. (2000) ArticleTitleAnalgesic effect of low-dose intrathecal morphine and bupivacaine in laparoscopic cholecystectomy Anaesthesiology 55 118 Occurrence Handle10.1046/j.1365-2044.2000.055002118.x Occurrence Handle1:CAS:528:DC%2BD3cXhtlCgtb0%3D

    Article  CAS  Google Scholar 

  15. BM Ure H Troidl W Spanberger et al. (1993) ArticleTitlePreincisional local anesthesia with bupivacaine and pain after laparoscopic cholecystectomy: a double-blind randomized clinical trial Surg. Endosc. 7 482 Occurrence Handle1:STN:280:ByuD1MfksFE%3D Occurrence Handle8272992

    CAS  PubMed  Google Scholar 

  16. KI Gharaibeh TM Al-Jaberi (2000) ArticleTitleBupivacaine instillation into gallbladder bed after laparoscopic cholecystectomy: does it decrease shoulder pain? J. Laparoendosc. Adv. Surg. Tech. 10 137 Occurrence Handle1:STN:280:DC%2BD3M%2FitVagsg%3D%3D

    CAS  Google Scholar 

  17. GM Hall JP Desborough (1992) ArticleTitleInterleukin-6 and the metabolic response to surgery Br. J. Anesth. 69 337 Occurrence Handle1:STN:280:ByyD2c%2FnslI%3D

    CAS  Google Scholar 

  18. AM Sarac AO Aktan N Baykan et al. (1996) ArticleTitleThe effect of timing of local anaesthesia in laparoscopic cholecystectomy Surg. Laparosc. Endosc. 6 362 Occurrence Handle10.1097/00019509-199610000-00005 Occurrence Handle1:STN:280:ByiD2crjs1E%3D Occurrence Handle8890420

    Article  CAS  PubMed  Google Scholar 

  19. JW Szem L Hydo PS Barie (1996) ArticleTitleA double-blinded evaluation of intraperitoneal bupivacaine vs. saline for reduction of postoperative pain and nausea after laparoscopic cholecystectomy Surg. Endosc. 10 44 Occurrence Handle10.1007/s004649910011 Occurrence Handle1:STN:280:BymB28znvVc%3D Occurrence Handle8711605

    Article  CAS  PubMed  Google Scholar 

  20. T Chundrigar R Morris AR Hedges et al. (1993) ArticleTitleIntraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy Ann. R. Coll. Surg. Engl. 75 437 Occurrence Handle1:STN:280:ByuC3MzlsVE%3D Occurrence Handle8285548

    CAS  PubMed  Google Scholar 

  21. A Helvacioglu R Weis (1992) ArticleTitleOperative laparoscopy and postoperative pain relief Fertil. Steril. 57 548 Occurrence Handle1:STN:280:By2C2Mrjsl0%3D Occurrence Handle1531467

    CAS  PubMed  Google Scholar 

  22. S Goegler M Blobner R Busley et al. (1993) ArticleTitleSubphrenic catheter for postoperative analgesia after laparoscopic cholecystectomy Anaesthesiology 79 A26

    Google Scholar 

  23. P Narchi D Benhamou H Fernandez (1991) ArticleTitleIntraperitoneal local anaesthetic for shoulder pain after day-case laparoscopy Lancet 338 1569 Occurrence Handle10.1016/0140-6736(91)92384-E Occurrence Handle1:STN:280:By2D2sbmsFU%3D Occurrence Handle1683981

    Article  CAS  PubMed  Google Scholar 

  24. B Mraovic T Jurisic VK Majeric et al. (1997) ArticleTitleIntraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomy Acta Anesthesiol. Scand. 41 193 Occurrence Handle1:CAS:528:DyaK2sXhvVejs7g%3D

    CAS  Google Scholar 

  25. BE Smith M Suchak D Siggins et al. (1988) ArticleTitleRectus sheath block for diagnostic laparoscopy Anaesthesiology 43 947 Occurrence Handle1:STN:280:BiaC3czotlY%3D

    CAS  Google Scholar 

  26. H Shoulte-Steinberg E Weninger D Jokisch et al. (1995) ArticleTitleIntraperitoneal versus interpleural morphine or bupivacaine for pain after laparoscopic cholecystectomy Anesthesiology 82 634 Occurrence Handle10.1097/00000542-199503000-00004 Occurrence Handle7879931

    Article  PubMed  Google Scholar 

  27. B Cox ME Durieux MA Marcus (2003) ArticleTitleToxicity of local anaesthetics Best Pract. Res. Clin. Anaesthesiol. 17 111 Occurrence Handle10.1053/bean.2003.0275 Occurrence Handle1:CAS:528:DC%2BD3sXitFagsbo%3D Occurrence Handle12751552

    Article  CAS  PubMed  Google Scholar 

  28. A Pasqualucci VD Angelis R Contardo et al. (1996) ArticleTitlePreemptive analgesia: intraperitoneal local anesthetic in laparoscopic cholecystectomy Anesthesiology 85 11 Occurrence Handle10.1097/00000542-199607000-00003 Occurrence Handle1:STN:280:BymB1M7hvFQ%3D Occurrence Handle8694355

    Article  CAS  PubMed  Google Scholar 

  29. JL Bourget J Clark N Joy (1997) ArticleTitleComparing preincisional with postincisional bupivacaine infiltration in the management of postoperative pain Arch. Surg. 132 766 Occurrence Handle1:CAS:528:DyaK2sXlt1Clu74%3D Occurrence Handle9230863

    CAS  PubMed  Google Scholar 

  30. A Pasqualucci (1998) ArticleTitleExperimental and clinical studies about the preemptive analgesia with local anaesthetics: possible reasons of the failure Minerva Anestesiol. 64 445 Occurrence Handle1:STN:280:DyaK1M%2FnsV2mtg%3D%3D Occurrence Handle9857627

    CAS  PubMed  Google Scholar 

  31. RW Ke SG Portera W Bagous et al. (1998) ArticleTitleA randomised, double blinded trial of preemptive analgesia in laparoscopy Obstet. Gynecol. 92 972 Occurrence Handle10.1016/S0029-7844(98)00303-2 Occurrence Handle1:STN:280:DyaK1M%2FlsVaqtw%3D%3D Occurrence Handle9840560

    Article  CAS  PubMed  Google Scholar 

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Inan, A., Sen, M. & Dener, C. Local Anesthesia Use for Laparoscopic Cholecystectomy. World J. Surg. 28, 741–744 (2004). https://doi.org/10.1007/s00268-004-7350-3

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