Abstract
Purpose
The aim of this study was to determine the effect of local anesthetic instillation, to compare bupivacaine and ropivacaine in patients undergoing a laparoscopic cholecystectomy.
Methods
A total of 80 patients were randomly assigned to four groups to receive the intraperitoneal instillation of 21 ml of either 100 mg bupivacaine (Group B), 100 mg ropivacaine (Group R1), 150 mg ropivacaine (Group R2) or saline with epinephrine 1/200 000 at the end of the surgery. The postoperative pain was evaluated and the analgesic requirement was also assessed.
Results
The intraperitoneal instillation of 100 mg bupivacaine, 100 mg ropivacaine, or 150 mg ropivacaine at the end of a laparoscopic cholecystectomy significantly reduced the morphine consumption during the first 24 h. For preventing postoperative pain 150 mg ropivacaine proved to be significantly more effective than either 100 mg bupivacaine or 100 mg ropivacaine.
Conclusion
We herein showed that the intraperitoneal instillation of local anesthetic during laparoscopic cholecystectomy is a noninvasive, rapid, safe and simple analgesic technique that reduces the total morphine consumption during first 24 h.
Article PDF
Similar content being viewed by others
References
J Joris I Cigarini M Legrand N Jacquet D De Groote P Franchimont et al. (1992) ArticleTitleMetabolic and respiratory changes after cholecystectomy performed via laparotomy or laparoscopy Br J Anaesth 69 IssueID4 341–5 Occurrence Handle1419439 Occurrence Handle10.1093/bja/69.4.341 Occurrence Handle1:STN:280:DyaK3s%2FktVOkug%3D%3D
AJ McMahon IT Russell G Ramsay G Sunderland JN Baxter JR Anderson et al. (1994) ArticleTitleLaparoscopic and minilaparotomy cholecystectomy: a randomized trial comparing postoperative pain and pulmonary function Surgery 115 IssueID5 533–9 Occurrence Handle8178250 Occurrence Handle1:STN:280:DyaK2c3jtlCrtw%3D%3D
B Mraovic T Jurisic V Kogler-Majeric A Sustic (1997) ArticleTitleIntraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomy Acta Anaesthesiol Scand 41 IssueID2 193–6 Occurrence Handle9062598 Occurrence Handle1:CAS:528:DyaK2sXhvVejs7g%3D
A Pasqualucci V de Angelis R Contardo F Colo G Terrosu A Donini et al. (1996) ArticleTitlePreemptive analgesia: intraperitoneal local anesthetic in laparoscopic cholecystectomy. A randomized, double-blind, placebo-controlled study Anesthesiology 85 IssueID1 11–20 Occurrence Handle8694355 Occurrence Handle10.1097/00000542-199607000-00003 Occurrence Handle1:STN:280:DyaK283ptFWqsg%3D%3D
VL Wills DR Hunt (2000) ArticleTitlePain after laparoscopic cholecystectomy (Review) Br J Surg 87 IssueID3 273–84 Occurrence Handle10718794 Occurrence Handle10.1046/j.1365-2168.2000.01374.x Occurrence Handle1:STN:280:DC%2BD3c7otleqsw%3D%3D
K Iwase H Takenaka T Ishizaka T Ohata S Oshima K Sakaguchi (1993) ArticleTitleSerial changes in renal function during laparoscopic cholecystectomy Eur Surg Res 25 IssueID4 203–12 Occurrence Handle8330637 Occurrence Handle1:STN:280:DyaK3szitFOgsw%3D%3D
ND Edwards K Barclay SJ Catling DG Martin RH Morgan (1991) ArticleTitleDay case laparoscopy: a survey of postoperative pain and an assessment of the value of diclofenac Anaesthesia 46 IssueID12 1077–80 Occurrence Handle1838235 Occurrence Handle10.1111/j.1365-2044.1991.tb09930.x Occurrence Handle1:STN:280:DyaK387ktlanug%3D%3D
M Rosenblum RS Weller PL Conard EA Falvey JB Gross (1991) ArticleTitleIbuprofen provides longer lasting analgesia than fentanyl after laparoscopic surgery Anesth Analg 73 IssueID3 255–9 Occurrence Handle1831017 Occurrence Handle10.1213/00000539-199109000-00004 Occurrence Handle1:STN:280:DyaK3MzivVCntQ%3D%3D
VK Comfort WE Code ME Rooney RW Yip (1992) ArticleTitleNaproxen premedication reduces postoperative tubal ligation pain Can J Anaesth 39 IssueID4 349–52 Occurrence Handle1348663 Occurrence Handle1:STN:280:DyaK383isVegtg%3D%3D
S Crocker M Paech (1992) ArticleTitlePreoperative rectal indomethacin for analgesia after laparoscopic sterilisation Anaesth Intensive Care 20 IssueID3 337–40 Occurrence Handle1388003 Occurrence Handle1:STN:280:DyaK38zpvVSitw%3D%3D
J Liu Y Ding PF White R Feinstein JM Shear (1993) ArticleTitleEffects of ketorolac on postoperative analgesia and ventilatory function after laparoscopic cholecystectomy Anesth Analg 76 IssueID5 1061–6 Occurrence Handle8484508 Occurrence Handle10.1213/00000539-199305000-00026 Occurrence Handle1:STN:280:DyaK3s3kvFSmtg%3D%3D
A Goldstein P Grimault A Henique M Keller A Fortin E Darai (2000) ArticleTitlePreventing postoperative pain by local anesthetic instillation after laparoscopic gynecologic surgery: a placebo-controlled comparison of bupivacaine and ropivacaine Anesth Analg 91 IssueID2 403–7 Occurrence Handle10910857 Occurrence Handle10.1097/00000539-200008000-00032 Occurrence Handle1:CAS:528:DC%2BD3cXlvVOqsrk%3D
P Narchi D Benhamou H Fernandez (1991) ArticleTitleIntraperitoneal local anaesthetic for shoulder pain after day-case laparoscopy Lancet 338 1569–70 Occurrence Handle1683981 Occurrence Handle10.1016/0140-6736(91)92384-E Occurrence Handle1:STN:280:DyaK38%2FnvFKmsw%3D%3D
DJ Sheskin (2004) Handbook of parametric and nonparametric statistical procedure EditionNumber3rd ed Chapman and Hall CRC Boca Raton 762–6
T Chundrigar AR Hedges R Morris JD Stamatakis (1993) ArticleTitleIntraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy Ann R Coll Surg Engl 75 IssueID6 437–9 Occurrence Handle8285548 Occurrence Handle1:STN:280:DyaK2c7htlGntw%3D%3D
P Narchi D Benhamou H Bouaziz H Fernandez JX Mazoit (1992) ArticleTitleSerum concentrations of local anaesthetics following intraperitoneal administration during laparoscopy Eur J Clin Pharmacol 42 IssueID2 223–5 Occurrence Handle1535592 Occurrence Handle10.1007/BF00278490 Occurrence Handle1:CAS:528:DyaK38XitVOhtbY%3D
J Joris E Thiry P Paris J Weerts M Lamy (1995) ArticleTitlePain after laparoscopic cholecystectomy: characteristics and effect of intraperitoneal bupivacaine Anesth Analg 81 IssueID2 379–84 Occurrence Handle7618731 Occurrence Handle10.1097/00000539-199508000-00029 Occurrence Handle1:STN:280:DyaK2MzksVShtQ%3D%3D
JW Szem L Hydo PS Barie (1996) ArticleTitleA double-blinded evaluation of intraperitoneal bupivacaine vs saline for the reduction of postoperative pain and nausea after laparoscopic cholecystectomy Surg Endosc 10 IssueID1 44–8 Occurrence Handle8711605 Occurrence Handle10.1007/s004649910011 Occurrence Handle1:STN:280:DyaK283mtlOrsQ%3D%3D
B Scheinin I Kellokumpu L Lindgren C Haglund PH Rosenberg (1995) ArticleTitleEffect of intraperitoneal bupivacaine on pain after laparoscopic cholecystectomy Acta Anaesthesiol Scand 39 IssueID2 195–8 Occurrence Handle7793186 Occurrence Handle1:STN:280:DyaK2MzhtlCksQ%3D%3D
T Labaille JX Mazoit X Paqueron D Franco D Benhamou (2002) ArticleTitleThe clinical efficacy and pharmacokinetics of intraperitoneal ropivacaine for laparoscopic cholecystectomy Anesth Analg 94 IssueID1 100–5 Occurrence Handle11772809 Occurrence Handle10.1097/00000539-200201000-00019 Occurrence Handle1:CAS:528:DC%2BD38Xmt1GitA%3D%3D
FF Dobbs V Kumar JI Alexander MG Hull (1987) ArticleTitlePain after laparoscopy related to posture and ring versus clip sterilization Br J Obstet Gynaecol 94 IssueID3 262–6 Occurrence Handle2952160 Occurrence Handle1:STN:280:DyaL2s7osFehsA%3D%3D
A Helvacioglu R Weis (1992) ArticleTitleOperative laparoscopy and postoperative pain relief Fertil Steril 57 IssueID3 548–52 Occurrence Handle1531467 Occurrence Handle1:STN:280:DyaK387lsFekuw%3D%3D
KM Collins PW Docherty OM Plantevin (1984) ArticleTitlePostoperative morbidity following gynaecological outpatient laparoscopy. A reappraisal of the service Anaesthesia 39 IssueID8 819–22 Occurrence Handle6236708 Occurrence Handle10.1111/j.1365-2044.1984.tb06534.x Occurrence Handle1:STN:280:DyaL2czgsV2isQ%3D%3D
AD Loughney V Sarma EA Ryall (1994) ArticleTitleIntraperitoneal bupivacaine for the relief of pain following day case laparoscopy Br J Obstet Gynaecol 101 IssueID5 449–51 Occurrence Handle8018622 Occurrence Handle1:STN:280:DyaK2c3ovFelug%3D%3D
GT Deans MS Wilson WA Brough (1998) ArticleTitleControlled trial of preperitoneal local anaesthetic for reducing pain following laparoscopic hernia repair Br J Surg 85 IssueID7 1013–4 Occurrence Handle9692587 Occurrence Handle10.1046/j.1365-2168.1998.00763.x Occurrence Handle1:STN:280:DyaK1czlsFeitw%3D%3D
A Ng G Smith (2002) ArticleTitleIntraperitoneal administration of analgesia: is this practice of any utility? Br J Anaesth 89 IssueID4 535–7 Occurrence Handle12393350 Occurrence Handle10.1093/bja/aef219 Occurrence Handle1:STN:280:DC%2BD38njsVGntQ%3D%3D
N Pettersson BM Emanuelsson H Reventlid RG Hahn (1998) ArticleTitleHigh-dose ropivacaine wound infiltration for pain relief after inguinal hernia repair: a clinical and pharmacokinetic evaluation Reg Anesth Pain Med 23 189–96 Occurrence Handle9570609 Occurrence Handle1:CAS:528:DyaK1cXislCjs7o%3D Occurrence Handle10.1097/00115550-199823020-00013
EP Horn F Schroeder S Wilhelm F Wappler DI Sessler B Uebe et al. (1999) ArticleTitleWound infiltration and drain lavage with ropivacaine after major shoulder surgery Anesth Analg 89 IssueID6 1461–6 Occurrence Handle10589629 Occurrence Handle10.1097/00000539-199912000-00027 Occurrence Handle1:CAS:528:DC%2BD3cXhsF2juw%3D%3D
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kucuk, C., Kadiogullari, N., Canoler, O. et al. A Placebo-Controlled Comparison of Bupivacaine and Ropivacaine Instillation for Preventing Postoperative Pain After Laparoscopic Cholecystectomy. Surg Today 37, 396–400 (2007). https://doi.org/10.1007/s00595-006-3408-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-006-3408-1