Skip to main content
SpringerLink
Log in

Intraperitoneal use of local anesthetic in laparoscopic cholecystectomy: systematic review and metaanalysis of randomized controlled trials

  • Review article
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background/purpose

With the advent of minimally invasive gallbladder surgery, and now with natural orifice techniques emerging, visceral nociception has been neglected as a cause of postoperative pain. A systematic review and metaanalysis was carried out to investigate the use of intraperitoneal local anesthetic (IPLA) in order to assess its role in laparoscopic cholecystectomy (LC). The aim of this systematic review was to appraise the clinical effects of this modality.

Methods

Comprehensive searches were conducted independently without language restriction. Studies were identified from the following databases from inception to September 2009: Cochrane Central Register of Controlled Trials (CENTRAL/CCTR), Cochrane Library, Medline, PubMed, Excerpta Medica Database (EMBASE), and Cumulative Index to Nursing and Allied Health Literature (CINHAL). Relevant meeting abstracts and reference lists were manually searched. Data analysis was performed using Review Manager Version 5.0 software.

Results

Thirty randomized controlled trials were identified for review. The clinical heterogeneity of IPLA use was high. However, there appeared to be reduced pain, opioid use, and need for rescue analgesia, and reduced postoperative cortisol and glucose responses.

Conclusion

There is evidence in favor of IPLA in LC. Further trials of this modality in LC are not needed as these are unlikely to reduce clinical heterogeneity. IPLA should be trialled as future minimally invasive surgical techniques approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Wills VL, Hunt DR. Pain after laparoscopic cholecystectomy. Br J Surg. 2000;87:273–84.

    Article  PubMed  CAS  Google Scholar 

  2. Kuon Lee S, You YK, Park JH, Kim HJ, Lee KK, Kim DG. Single-port transumbilical laparoscopic cholecystectomy: a preliminary study in 37 patients with gallbladder disease. J Laparoendosc Adv Surg Tech A. 2009;19:495–9.

    Article  PubMed  Google Scholar 

  3. Gumbs AA, Fowler D, Milone L, Evanko JC, Ude AO, Stevens P, et al. Transvaginal natural orifice translumenal endoscopic surgery cholecystectomy: early evolution of the technique. Ann Surg. 2009;249:908–12.

    Article  PubMed  Google Scholar 

  4. Cervero F, Laird JM. Visceral pain. Lancet. 1999;353:2145–8.

    Article  PubMed  CAS  Google Scholar 

  5. Burns AJ, Pachnis V. Development of the enteric nervous system: bringing together cells, signals and genes. Neurogastroenterol Motil. 2009;21:100–2.

    Article  PubMed  CAS  Google Scholar 

  6. Bielefeldt K, Christianson JA, Davis BM. Basic and clinical aspects of visceral sensation: transmission in the CNS. Neurogastroenterol Motil. 2005;17:488–99.

    Article  PubMed  CAS  Google Scholar 

  7. Grundy D, Al-Chaer ED, Aziz Q, Collins SM, Ke M, Tache Y, et al. Fundamentals of neurogastroenterology: basic science. Gastroenterology. 2006;130:1391–411.

    Article  PubMed  CAS  Google Scholar 

  8. Kehlet H, Liu SS. Continuous local anesthetic wound infusion to improve postoperative outcome: back to the periphery? Anesthesiology. 2007;107:369–71.

    Article  PubMed  Google Scholar 

  9. Hanson IR, Hingson RA. The use of xylocaine, a new local anesthetic, in surgery, obstetrics and therapeutics. Curr Res Anesth Analg. 1950;29:136–47.

    PubMed  CAS  Google Scholar 

  10. Griffin EM, Prystowsky H, Hingson RA. The use of topical anaesthesia of the peritoneum in poor risk surgery and in augmenting inadequate vertebral conduction anaesthesia. N Z Med J. 1951;50:31–3.

    PubMed  CAS  Google Scholar 

  11. Ajao OG. The use of local anaesthetics for emergency abdominal operations. Trop Doct. 1978;8:73–5.

    PubMed  CAS  Google Scholar 

  12. Penfield AJ. Laparoscopic sterilization under local anesthesia. 1200 cases. Obstet Gynecol. 1977;49:725–7.

    PubMed  CAS  Google Scholar 

  13. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet. 1999;354:1896–900.

    Article  PubMed  CAS  Google Scholar 

  14. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12.

    Article  PubMed  CAS  Google Scholar 

  15. Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions. Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008. Available from http://www.cochrane-handbook.org.

  16. Pereira J, Lawlor P, Vigano A, Dorgan M, Bruera E. Equianalgesic dose ratios for opioids. A critical review and proposals for long-term dosing. J Pain Symptom Manage. 2001;22:672–87.

    Article  PubMed  CAS  Google Scholar 

  17. Lawlor P, Pereira J, Bruera E. Dose ratios among different Opioids: underlying issues and an update on the use of the Equianalgesic Table. In: Bruera E, Portenoy RK, editors. Topices in palliative care, vol. 5. New York: Oxford University Press; 2001.

  18. Ades AE, Lu G, Higgins JP. The interpretation of random-effects meta-analysis in decision models. Med Decis Making. 2005;25:646–54.

    Article  PubMed  CAS  Google Scholar 

  19. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.

    Article  PubMed  Google Scholar 

  20. Gharaibeh KI, Al-Jaberi TM. Bupivacaine instillation into gallbladder bed after laparoscopic cholecystectomy: does it decrease shoulder pain? J Laparoendosc Adv Surg Tech A. 2000;10:137–41.

    Article  PubMed  CAS  Google Scholar 

  21. Goegler S, Blobner M, Busley R. Subphrenic catheter for postoperative analgesia after laparoscopic cholecystectomy (abstract). Anesthesiology. 1993;79:A26.

    Google Scholar 

  22. Hafez MHS, Osman M, Helmy N, Morrah R, Halim MSAA. Intraperitoneal lidocaine (Xylocaine) during laparoscopic cholecystectomy: a preliminary study. Med J Cairo Univ. 1995;63:55–61.

    Google Scholar 

  23. Sozbilen M, Yeniay L, Unalp M, Makay O, Pirim A, Ulukaya S, et al. Effects of ropivacaine on pain after laparoscopic cholecystectomy: a prospective, randomized study. Adv Ther. 2007;24:247–57.

    Article  PubMed  CAS  Google Scholar 

  24. Fornari M, Miglietta C, Di Gioia S, Garrone C, Morino M. The use of intraoperative topical bupivacaine in the control of postoperative pain following laparoscopic cholecystectomy. Minerva Chir. 1996;51:881–5.

    PubMed  CAS  Google Scholar 

  25. Hazinedaroglu SM, Kayaoglu HA, Ates Y, Erturk S, Butuner C, Turkcapar AG. Intraperitoneal bupivacaine for postoperative pain relief after laparoscopic cholecystectomy. Pain Med. 2006;7:539–41.

    Article  PubMed  Google Scholar 

  26. Karadeniz U, Erdemli O, Unver S. Intraperitoneal bupivacaine infusion and injection for postoperative pain management in laparoscopic cholecystectomy. Anestezi Dergisi. 2003;11:226–30.

    Google Scholar 

  27. Lee IO, Kim SH, Kong MH, Lee MK, Kim NS, Choi YS, et al. Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine. Can J Anaesth. 2001;48:545–50.

    Article  PubMed  CAS  Google Scholar 

  28. Moreira W, Amatto P, Cardoso-Bessa R, Belchior-Silva J. Intraperitoneal bupivacaine for pain relief after laparoscopic cholecystectomy. Rev Bras Anestesiol. 2000;50:283–8.

    Google Scholar 

  29. Paulson J, Mellinger J, Baguley W. The use of intraperitoneal bupivacaine to decrease the length of stay in elective laparoscopic cholecystectomy patients. Am Surg. 2003;69:275–8. (discussion 278–9).

    PubMed  Google Scholar 

  30. Thiry E, Paris P, Weerts J, Joris J. Intraperitoneal bupivacaine does not reduce postoperative pain after laparoscopic cholecystectomy (abstract). Br J Anaesth. 1994;72:120.

    Google Scholar 

  31. Zmora O, Stolik-Dollberg O, Bar-Zakai B, Rosin D, Kuriansky J, Shabtai M, et al. Intraperitoneal bupivacaine does not attenuate pain following laparoscopic cholecystectomy. JSLS. 2000;4:301–4.

    PubMed  CAS  Google Scholar 

  32. Bisgaard T, Klarskov B, Kristiansen VB, Callesen T, Schulze S, Kehlet H, et al. Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study. Anesth Analg. 1999;89:1017–24.

    Article  PubMed  CAS  Google Scholar 

  33. Elhakim M, Amine H, Kamel S, Saad F. Effects of intraperitoneal lidocaine combined with intravenous or intraperitoneal tenoxicam on pain relief and bowel recovery after laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 2000;44:929–33.

    Article  PubMed  CAS  Google Scholar 

  34. Maharjan SK, Shrestha S. Intraperitoneal and periportal injection of bupivacaine for pain after laparoscopic cholecystectomy. Kathmandu Univ Med J (KUMJ). 2009;7:50–3.

    CAS  Google Scholar 

  35. Schulte-Steinberg H, Weninger E, Jokisch D, Hofstetter B, Misera A, Lange V, et al. Intraperitoneal versus interpleural morphine or bupivacaine for pain after laparoscopic cholecystectomy. Anesthesiology. 1995;82:634–40.

    Article  PubMed  CAS  Google Scholar 

  36. Kilic A, Basgul E, Ozdemir A, Erdem M. The efficacy of the intraperitoneal bupivacaine application on early postoperative pain and blood gas values after laparoscopic cholecystectomy. Agri Dergisi. 1996;8:20–6.

    Google Scholar 

  37. Scheinin B, Kellokumpu I, Lindgren L, Haglund C, Rosenberg PH. Effect of intraperitoneal bupivacaine on pain after laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 1995;39:195–8.

    Article  PubMed  CAS  Google Scholar 

  38. Wulf H, Leger R, Raetzell M, Olmer A, Scheiderer U. Cholestasis as a side effect of bupivacaine? Reg Anesth Pain Med. 1998;23:278–82.

    PubMed  CAS  Google Scholar 

  39. Chundrigar T, Hedges AR, Morris R, Stamatakis JD. Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy. Ann R Coll Surg Engl. 1993;75:437–9.

    PubMed  CAS  Google Scholar 

  40. Pasqualucci A, Contardo R, Da Broi U, Colo F, Terrosu G, Donini A, et al. The effects of intraperitoneal local anesthetic on analgesic requirements and endocrine response after laparoscopic cholecystectomy: a randomized double-blind controlled study. J Laparoendosc Surg. 1994;4:405–12.

    PubMed  CAS  Google Scholar 

  41. Rademaker BM, Kalkman CJ, Odoom JA, de Wit L, Ringers J. Intraperitoneal local anaesthetics after laparoscopic cholecystectomy: effects on postoperative pain, metabolic responses and lung function. Br J Anaesth. 1994;72:263–6.

    Article  PubMed  CAS  Google Scholar 

  42. Joris J, Thiry E, Paris P, Weerts J, Lamy M. Pain after laparoscopic cholecystectomy: characteristics and effect of intraperitoneal bupivacaine. Anesth Analg. 1995;81:379–84.

    Article  PubMed  CAS  Google Scholar 

  43. Raetzell M, Maier C, Schroder D, Wulf H. Intraperitoneal application of bupivacaine during laparoscopic cholecystectomy–risk or benefit? Anesth Analg. 1995;81:967–72.

    Article  PubMed  CAS  Google Scholar 

  44. Fuhrer Y, Charpentier C, Boulanger G, Menu N, Grosdidier G, Laxenaire MC. Analgesia after laparoscopic cholecystectomy by intraperitoneal administration of bupivacaine. Ann Fr Anesth Reanim. 1996;15:128–34.

    PubMed  CAS  Google Scholar 

  45. Pasqualucci A, de Angelis V, Contardo R, Colo F, Terrosu G, Donini A, et al. Preemptive analgesia: intraperitoneal local anesthetic in laparoscopic cholecystectomy. A randomized, double-blind, placebo-controlled study. Anesthesiology. 1996;85:11–20.

    Article  PubMed  CAS  Google Scholar 

  46. Szem JW, Hydo L, Barie PS. A double-blinded evaluation of intraperitoneal bupivacaine vs saline for the reduction of postoperative pain and nausea after laparoscopic cholecystectomy. Surg Endosc. 1996;10:44–8.

    Article  PubMed  CAS  Google Scholar 

  47. Mraovic B, Jurisic T, Kogler-Majeric V, Sustic A. Intraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 1997;41:193–6.

    Article  PubMed  CAS  Google Scholar 

  48. Tsimoyiannis EC, Glantzounis G, Lekkas ET, Siakas P, Jabarin M, Tzourou H. Intraperitoneal normal saline and bupivacaine infusion for reduction of postoperative pain after laparoscopic cholecystectomy. Surg Laparosc Endosc. 1998;8:416–20.

    Article  PubMed  CAS  Google Scholar 

  49. Elfberg BA, Sjovall-Mjoberg S. Intraperitoneal bupivacaine does not effectively reduce pain after laparoscopic cholecystectomy: a randomized, placebo-controlled and double-blind study. Surg Laparosc Endosc Percutan Tech. 2000;10:357–9.

    PubMed  CAS  Google Scholar 

  50. Jiranantarat V, Rushatamukayanunt W, Lert-akyamanee N, Sirijearanai R, Piromrat I, Suwannanonda P. et al. Analgesic effect of intraperitoneal instillation of bupivacaine for postoperative laparoscopic cholecystectomy. J Med Assoc Thai. 2002;85(Suppl 3):S897–903.

    PubMed  Google Scholar 

  51. Hernandez-Palazon J, Tortosa JA, Nuno de la Rosa V, Gimenez-Viudes J, Ramirez G, Robles R. Intraperitoneal application of bupivacaine plus morphine for pain relief after laparoscopic cholecystectomy. Eur J Anaesthesiol. 2003;20:891–6.

    Article  PubMed  CAS  Google Scholar 

  52. Jabbour-Khoury SI, Dabbous AS, Gerges FJ, Azar MS, Ayoub CM, Khoury GS. Intraperitoneal and intravenous routes for pain relief in laparoscopic cholecystectomy. J Soc Lapendoscop Surg. 2005;9:316–21.

    Google Scholar 

  53. Barczynski M, Konturek A, Herman RM. Superiority of preemptive analgesia with intraperitoneal instillation of bupivacaine before rather than after the creation of pneumoperitoneum for laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled study. Surg Endosc. 2006;20:1088–93.

    Article  PubMed  CAS  Google Scholar 

  54. Karaaslan D, Sivaci RG, Akbulut G, Dilek ON. Preemptive analgesia in laparoscopic cholecystectomy: a randomized controlled study. Pain Pract. 2006;6:237–41.

    Article  PubMed  Google Scholar 

  55. Alkhamesi NA, Peck DH, Lomax D, Darzi AW. Intraperitoneal aerosolization of bupivacaine reduces postoperative pain in laparoscopic surgery: a randomized prospective controlled double-blinded clinical trial. Surg Endosc. 2007;21:602–6.

    Article  PubMed  CAS  Google Scholar 

  56. Garcia JBS, Junior AMA, Santos CEC. Intraperitoneal administration of 50% enantiomeric excess (S75–R25) bupivacaine in postoperative analgesia of laparoscopic cholecystectomy. Rev Bras Anestesiol. 2007;57:344–55.

    Article  PubMed  CAS  Google Scholar 

  57. Kucuk C, Kadiogullari N, Canoler O, Savli S. A placebo-controlled comparison of bupivacaine and ropivacaine instillation for preventing postoperative pain after laparoscopic cholecystectomy. Surg Today. 2007;37:396–400.

    Article  PubMed  CAS  Google Scholar 

  58. Ahmed BH, Ahmed A, Tan D, Awad ZT, Al-Aali AY, Kilkenny J 3rd, et al. Post-laparoscopic cholecystectomy pain: effects of intraperitoneal local anesthetics on pain control—a randomized prospective double-blinded placebo-controlled trial. Am Surg. 2008;74:201–9.

    PubMed  Google Scholar 

  59. Golubovic S, Golubovic V, Cindric-Stancin M, Tokmadzic VS. Intraperitoneal analgesia for laparoscopic cholecystectomy: bupivacaine versus bupivacaine with tramadol. Coll Antropol. 2009;33:299–302.

    PubMed  CAS  Google Scholar 

  60. Gupta A, Thorn SE, Axelsson K, Larsson LG, Agren G, Holmstrom B, et al. Postoperative pain relief using intermittent injections of 0.5% ropivacaine through a catheter after laparoscopic cholecystectomy. Anesth Analg. 2002;95:450–6. (table of contents).

    Article  PubMed  CAS  Google Scholar 

  61. Labaille T, Mazoit JX, Paqueron X, Franco D, Benhamou D. The clinical efficacy and pharmacokinetics of intraperitoneal ropivacaine for laparoscopic cholecystectomy. Anesth Analg. 2002;94:100–5. (table of contents).

    Article  PubMed  CAS  Google Scholar 

  62. Maestroni U, Sortini D, Devito C, Pour Morad Kohan Brunaldi F, Anania G, Pavanelli L, et al. A new method of preemptive analgesia in laparoscopic cholecystectomy. Surg Endosc. 2002;16:1336–40.

    Article  PubMed  CAS  Google Scholar 

  63. Pappas-Gogos G, Tsimogiannis KE, Zikos N, Nikas K, Manataki A, Tsimoyiannis EC. Preincisional and intraperitoneal ropivacaine plus normal saline infusion for postoperative pain relief after laparoscopic cholecystectomy: a randomized double-blind controlled trial. Surg Endosc. 2008;22:2036–45.

    Article  PubMed  Google Scholar 

  64. Elhakim M, Elkott M, Ali NM, Tahoun HM. Intraperitoneal lidocaine for postoperative pain after laparoscopy. Acta Anaesthesiol Scand. 2000;44:280–4.

    Article  PubMed  CAS  Google Scholar 

  65. Lepner U, Goroshina J, Samarutel J. Postoperative pain relief after laparoscopic cholecystectomy: a randomised prospective double-blind clinical trial. Scand J Surg. 2003;92:121–4.

    PubMed  CAS  Google Scholar 

  66. Ng A, Swami A, Smith G, Robertson G, Lloyd DM. Is intraperitoneal levobupivacaine with epinephrine useful for analgesia following laparoscopic cholecystectomy? A randomized controlled trial. Eur J Anaesthesiol. 2004;21:653–7.

    PubMed  CAS  Google Scholar 

  67. Louizos AA, Hadzilia SJ, Leandros E, Kouroukli IK, Georgiou LG, Bramis JP. Postoperative pain relief after laparoscopic cholecystectomy: a placebo-controlled double-blind randomized trial of preincisional infiltration and intraperitoneal instillation of levobupivacaine 0.25%. Surg Endosc. 2005;19:1503–6.

    Article  PubMed  CAS  Google Scholar 

  68. Papadima A, Lagoudianakis EE, Antonakis P, Filis K, Makri I, Markogiannakis H, et al. Repeated intraperitoneal instillation of levobupivacaine for the management of pain after laparoscopic cholecystectomy. Surgery. 2009;146:475–82.

    Article  PubMed  Google Scholar 

  69. Knudsen K, Beckman Suurkula M, Blomberg S, Sjovall J, Edvardsson N. Central nervous and cardiovascular effects of i.v. infusions of ropivacaine, bupivacaine and placebo in volunteers. Br J Anaesth. 1997;78:507–14.

    PubMed  CAS  Google Scholar 

  70. Maier SF, Goehler LE, Fleshner M, Watkins LR. The role of the vagus nerve in cytokine-to-brain communication. Ann NY Acad Sci. 1998;840:289–300.

    Article  PubMed  CAS  Google Scholar 

  71. Marret E, Rolin M, Beaussier M, Bonnet F. Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br J Surg. 2008;95:1331–8.

    Article  PubMed  CAS  Google Scholar 

  72. MacGregor RR, Thorner RE, Wright DM. Lidocaine inhibits granulocyte adherence and prevents granulocyte delivery to inflammatory sites. Blood. 1980;56:203–9.

    PubMed  CAS  Google Scholar 

  73. Martinsson T, Oda T, Fernvik E, Roempke K, Dalsgaard CJ, Svensjo E. Ropivacaine inhibits leukocyte rolling, adhesion and CD11b/CD18 expression. J Pharmacol Exp Ther. 1997;283:59–65.

    PubMed  CAS  Google Scholar 

  74. Rimback G, Cassuto J, Wallin G, Westlander G. Inhibition of peritonitis by amide local anesthetics. Anesthesiology. 1988;69:881–6.

    Article  PubMed  CAS  Google Scholar 

  75. Zhitniuk RI, Kataeva GA. Intraperitoneal infusions of novocaine after laparotomies for the prevention of intraperitoneal adhesions. Khirurgiia (Mosk). 1974; 67–9.

  76. Eriksson AS, Sinclair R, Cassuto J, Thomsen P. Influence of lidocaine on leukocyte function in the surgical wound. Anesthesiology. 1992;77:74–8.

    Article  PubMed  CAS  Google Scholar 

  77. Sasagawa S. Inhibitory effects of local anesthetics on migration, extracellular release of lysosomal enzyme, and superoxide anion production in human polymorphonuclear leukocytes. Immunopharmacol Immunotoxicol. 1991;13:607–22.

    Article  PubMed  CAS  Google Scholar 

  78. Lan W, Harmon D, Wang JH, Shorten G, Redmond P. The effect of lidocaine on neutrophil CD11b/CD18 and endothelial ICAM-1 expression and IL-1beta concentrations induced by hypoxia-reoxygenation. Eur J Anaesthesiol. 2004;21:967–72.

    PubMed  CAS  Google Scholar 

  79. Cullen BF, Haschke RH. Local anesthetic inhibition of phagocytosis and metabolism of human leukocytes. Anesthesiology. 1974;40:142–6.

    Article  PubMed  CAS  Google Scholar 

  80. Manku MS, Horrobin DF. Chloroquine, quinine, procaine, quinidine, tricyclic antidepressants, and methylxanthines as prostaglandin agonists and antagonists. Lancet. 1976;2:1115–7.

    Article  PubMed  CAS  Google Scholar 

  81. Boddy AP, Mehta S, Rhodes M. The effect of intraperitoneal local anesthesia in laparoscopic cholecystectomy: a systematic review and meta-analysis. Anesth Analg. 2006;103:682–8.

    Article  PubMed  CAS  Google Scholar 

  82. Gupta A. Local anaesthesia for pain relief after laparoscopic cholecystectomy—a systematic review. Best Pract Res Clin Anaesthesiol. 2005;19:275–92.

    Article  PubMed  CAS  Google Scholar 

  83. Moiniche S, Jorgensen H, Wetterslev J, Dahl JB. Local anesthetic infiltration for postoperative pain relief after laparoscopy: a qualitative and quantitative systematic review of intraperitoneal, port-site infiltration and mesosalpinx block. Anesth Analg. 2000;90:899–912.

    Article  PubMed  CAS  Google Scholar 

  84. Alkhamesi NA, Ridgway PF, Ramwell A, McCullough PW, Peck DH, Darzi AW. Peritoneal nebulizer: a novel technique for delivering intraperitoneal therapeutics in laparoscopic surgery to prevent locoregional recurrence. Surg Endosc. 2005;19:1142–6.

    Article  PubMed  CAS  Google Scholar 

  85. Greib N, Schlotterbeck H, Dow WA, Joshi GP, Geny B, Diemunsch PA. An evaluation of gas humidifying devices as a means of intraperitoneal local anesthetic administration for laparoscopic surgery. Anesth Analg. 2008;107:549–51.

    Article  PubMed  CAS  Google Scholar 

  86. Gupta A, Perniola A, Axelsson K, Thorn SE, Crafoord K, Rawal N. Postoperative pain after abdominal hysterectomy: a double-blind comparison between placebo and local anesthetic infused intraperitoneally. Anesth Analg. 2004;99:1173–9. (table of contents).

    Article  PubMed  CAS  Google Scholar 

  87. Ilfeld BM, Morey TE, Enneking FK. New portable infusion pumps: real advantages or just more of the same in a different package? Reg Anesth Pain Med. 2004;29:371–6.

    PubMed  Google Scholar 

  88. Rawal N, Axelsson K, Hylander J, Allvin R, Amilon A, Lidegran G, et al. Postoperative patient-controlled local anesthetic administration at home. Anesth Analg. 1998;86:86–9.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This research was conducted during tenure of the Ruth Spencer fellowship from the Auckland Medical Research Foundation, held by Arman Kahokehr, and the Surgeon Scientist Scholarship from the Royal Australasian College of Surgeons, held by Tarik Sammour. The authors would like to thank Drs Emmanuelle Cognard, Elizaveta Sopina, and Irene Vorontsova for their valuable time and help with translation of articles. The authors would also like to thank the library team at Middlememore Hospital: Jill Unsworth, Joanna Martin, Patricia Hayward, Heather Steedman, and Vicki Chetham, for their efforts in retrieving articles.

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand

    Arman Kahokehr, Tarik Sammour, Mattias Soop & Andrew G. Hill

  2. South Auckland Clinical School, University of Auckland, Private Bag 93311, Otahuhu, Auckland, New Zealand

    Arman Kahokehr

Authors
  1. Arman Kahokehr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tarik Sammour
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mattias Soop
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrew G. Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arman Kahokehr.

About this article

Cite this article

Kahokehr, A., Sammour, T., Soop, M. et al. Intraperitoneal use of local anesthetic in laparoscopic cholecystectomy: systematic review and metaanalysis of randomized controlled trials. J Hepatobiliary Pancreat Sci 17, 637–656 (2010). https://doi.org/10.1007/s00534-010-0271-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-010-0271-7

Keywords

Search

Navigation