Research Article
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Year 2018, Volume: 4 Issue: 4, 326 - 332, 04.10.2018
https://doi.org/10.18621/eurj.345129

Abstract

References

  • [1] Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy. The new “gold standard”? Arch Surg 1992;127:917-21.
  • [2] 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.
  • [3] Joshipura VP, Haribhakti SP, Patel NR, Naik RP, Sani HN, Patel B, et al. A prospective randomized, controlled study comparing low pressure versus high pressure pneumoperitoneum during laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 2009;19:234-40.
  • [4] Viyaraghavan N, Sistla SC, Kundra P, Ananthanarayan PH, Karthikeyan VS, Ali SM, et al. Comparison of standard-pressure and low-pressure pneumoperitoneum in laparoscopic cholecystectomy: a double-blind randomized controlled study. Surg Laparosc Endosc Percutan Tech 2014;24:127-33.
  • [5] Bisgaard T, Klarskow B, Kristiansen VB, Callesen T, Shulze S, Kehelet H, et al. Multiregional 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.
  • [6] Lewis DL, Thompson WA. Reduction of post operative pain. BMJ 1953;1:973-4.
  • [7] Pirbudak L, Balat Ö, Karadali H, Ugur MG, Öner Ü. Intraperitoneal and abdominal wall infiltration with bupivacaine plus tramadol and tenoxicam after total abdominal hysterectomy provides analgesia. Pain Clin 2004;16:77-81.
  • [8] Tiippana E, Bachmann M, Kalso E, Pere P. Effect of paracetamol and coxib with or without dexamethasone after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 2008;52:673-80.
  • [9] Akinci SB, Ayhan B, Aycan IO, Tirnaksiz B, Basgul E, Abbasoglu O, et al. The postoperative analgesic efficacy of intraperitoneal tramadol compared to normal saline or intravenous tramadol in laparoscopic cholecystectomy. Eur J Anaesthesiol 2008;25:375-81.
  • [10] 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.
  • [11] Collard V, Mistraletti G, Taqi A, Asenjo JF, Feldman LS, Fried GM, et al. Intraoperative esmolol infusion in the absence of opioids spares postoperative fentanyl in patients undergoing ambulatory laparoscopic cholecystectomy. Anesth Analg 2007;105:1255-62.
  • [12] Gupta R, Bogra J, Kothari N, Kohli M. Postoperative analgesia with intraperitoneal fentanyl and bupivacaine: A randomized control trial. Can J Med 2010;1:1-11.
  • [13] 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.
  • [14] 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.
  • [15] Papadima A, Lagoudianakis EE, Antonakis P, Filis K, Makri I, Markogiannakis H, et al. Repeated intra-peritoneal instillation of levobupivacaine for the management of pain after laparoscopic cholecystectomy. Surgery 2009;146:475-82.
  • [16] 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 Anesth 2001;48:545-50.
  • [17] Inan A, Sen M, Dener C. Local anaesthesia use for laparoscopic cholecystectomy. World J Surg 2004;28:741-4.
  • [18] American Society of Hospital Pharmacists, Committee on Pharmacy and Pharmaceuticals. American hospital formulary service: a collection of drug monographs and other information. Hamilton (IL): Hamilton Press, 1996.
  • [19] Lin S, Hua J, Xu B, Yang T, He Z, Xu C, et al. Comparison of bupivacaine and parecoxib
for postoperative pain relief after laparoscopic cholecystectomy: a randomized controlled trial. Int J Clin Exp Med 2015;8:13824-9.
  • [20] Papagiannapoulou P, Argiriadou H, Georgiou M, Papaziagos B, Sfyra E, Kanakoudis F. Preincisional local infiltration of levobupivacaine vs. ropivacaine for pain control after laparoscopic cholecystectomy. Surg Endosc 2003;17:1961-4.
  • [21] Uzunkoy A, Coskun A, Akinci. The value of pre-emptive analgesia in the treatment of postoperative pain after laparoscopic cholecystectomy. Eur Surg Res 2001;33:39-41.
  • [22] Cantore F, Boni L, Di Giuseppe M, Giavarini L, Rovera F, Dionigi G. Pre-incision local infiltration with levobupivacaine reduces pain and analgesic consumption after laparoscopic cholecystectomy: a new device for day-case procedure. Int J Surg. 2008;6;89-92.
  • [23] Effectiveness of local anesthetics in laparoscopic cholecystectomy: a randomized clinical trial. Surg Laparosc Endosc Percutan Tech 2015;25:317-20.
  • [24] Hilvering B, Draaisma WA, vander Bilt JD, Valk RM, Kofman KE, Consten EC. Randomized clinical trial of combined preincional infiltration and intrperitoneal instillation of levobupivacaine for postoperative pain after laparoscopic cholcystectomy. Br J Surg 2011;98:784-9.
  • [25] Ingelmo PM, Bucciero M, Somaini M, Sahillioglu E, Garbagnati A, Charton A, et al. Intraperitoneal nebulization of ropivacaine for pain control after laparoscopic cholecystectomy: A double‐ blind, randomized, placebo‐controlled trial. Br J Anaesth 2013;110:800-6.
  • [26] Montroni I, Sabattini E, Ramadori E, Koprivica V, Ugolini G, Locatelli F, et al. Small bowel obstruction caused by a large B-cell lymphoma in a patient with multicentric Castleman’s disease: an unusual occurrence. Int J Surg Pathol 2014;22:434-7.
  • [27] Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer HJ, Cuschieri A, et al. The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc 2002;16:1121-43.

Impact of low-pressure pneumoperitoneum and local anesthetic combination on postoperative pain in patients undergoing laparoscopic cholecystectomy

Year 2018, Volume: 4 Issue: 4, 326 - 332, 04.10.2018
https://doi.org/10.18621/eurj.345129

Abstract

Objectives: Despite the advantages of laparoscopic cholecystectomy
(LC), postoperative pain remains a
major complaint for many patients. In this study, in patients undergoing
LC, the application of LC
via incisional
bupivacaine and low inflation pressure, alone or combined, and a comparison of
the effects on postoperative pain has been purposed.

Methods: Patients were randomly
assigned into the following 4 groups: the standard pressure (SP) group (n =
30); patients with an intraabdominal insufflation pressure of 12 mmHg, where
bupivacaine application was not performed at the trocar locations. The SP+
local anesthetic (LA) (SP+LA) group (n =
30); patients with an intraabdominal insufflation pressure of 12 mmHg,
where bupivacaine
application was performed at the trocar locations
. The low pressure (LP) group
(n = 30); patients with an intraabdominal insufflation pressure of 8 mmHg
, where bupivacaine application was not
performed at the trocar locations
. The (LP+LA) group (n = 30); patients with an
intraabdominal insufflation pressure of 8 mmHg,
where bupivacaine
application was performed at the trocar locations
.
Postoperative pain was evaluated using the v
isual analogous scale (VAS).

Results: When the relationships
between the VAS scores, gender, age, and American Society of Anesthesiologists
classification were
evaluated, no significant relationships
between the groups were observed (p
> 0.05). A significant relationship between the groups was detected with
regards to the VAS scores, 1st analgesic application, 2nd
analgesic application, and patients’ satisfaction (p < 0.05).

Conclusions: The combination of low
insufflation pressure with intrafacial preincisional local anesthetic
infiltration in post-LC pain palliation is thought to be more effective and
applicable. 

References

  • [1] Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy. The new “gold standard”? Arch Surg 1992;127:917-21.
  • [2] 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.
  • [3] Joshipura VP, Haribhakti SP, Patel NR, Naik RP, Sani HN, Patel B, et al. A prospective randomized, controlled study comparing low pressure versus high pressure pneumoperitoneum during laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 2009;19:234-40.
  • [4] Viyaraghavan N, Sistla SC, Kundra P, Ananthanarayan PH, Karthikeyan VS, Ali SM, et al. Comparison of standard-pressure and low-pressure pneumoperitoneum in laparoscopic cholecystectomy: a double-blind randomized controlled study. Surg Laparosc Endosc Percutan Tech 2014;24:127-33.
  • [5] Bisgaard T, Klarskow B, Kristiansen VB, Callesen T, Shulze S, Kehelet H, et al. Multiregional 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.
  • [6] Lewis DL, Thompson WA. Reduction of post operative pain. BMJ 1953;1:973-4.
  • [7] Pirbudak L, Balat Ö, Karadali H, Ugur MG, Öner Ü. Intraperitoneal and abdominal wall infiltration with bupivacaine plus tramadol and tenoxicam after total abdominal hysterectomy provides analgesia. Pain Clin 2004;16:77-81.
  • [8] Tiippana E, Bachmann M, Kalso E, Pere P. Effect of paracetamol and coxib with or without dexamethasone after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 2008;52:673-80.
  • [9] Akinci SB, Ayhan B, Aycan IO, Tirnaksiz B, Basgul E, Abbasoglu O, et al. The postoperative analgesic efficacy of intraperitoneal tramadol compared to normal saline or intravenous tramadol in laparoscopic cholecystectomy. Eur J Anaesthesiol 2008;25:375-81.
  • [10] 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.
  • [11] Collard V, Mistraletti G, Taqi A, Asenjo JF, Feldman LS, Fried GM, et al. Intraoperative esmolol infusion in the absence of opioids spares postoperative fentanyl in patients undergoing ambulatory laparoscopic cholecystectomy. Anesth Analg 2007;105:1255-62.
  • [12] Gupta R, Bogra J, Kothari N, Kohli M. Postoperative analgesia with intraperitoneal fentanyl and bupivacaine: A randomized control trial. Can J Med 2010;1:1-11.
  • [13] 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.
  • [14] 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.
  • [15] Papadima A, Lagoudianakis EE, Antonakis P, Filis K, Makri I, Markogiannakis H, et al. Repeated intra-peritoneal instillation of levobupivacaine for the management of pain after laparoscopic cholecystectomy. Surgery 2009;146:475-82.
  • [16] 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 Anesth 2001;48:545-50.
  • [17] Inan A, Sen M, Dener C. Local anaesthesia use for laparoscopic cholecystectomy. World J Surg 2004;28:741-4.
  • [18] American Society of Hospital Pharmacists, Committee on Pharmacy and Pharmaceuticals. American hospital formulary service: a collection of drug monographs and other information. Hamilton (IL): Hamilton Press, 1996.
  • [19] Lin S, Hua J, Xu B, Yang T, He Z, Xu C, et al. Comparison of bupivacaine and parecoxib
for postoperative pain relief after laparoscopic cholecystectomy: a randomized controlled trial. Int J Clin Exp Med 2015;8:13824-9.
  • [20] Papagiannapoulou P, Argiriadou H, Georgiou M, Papaziagos B, Sfyra E, Kanakoudis F. Preincisional local infiltration of levobupivacaine vs. ropivacaine for pain control after laparoscopic cholecystectomy. Surg Endosc 2003;17:1961-4.
  • [21] Uzunkoy A, Coskun A, Akinci. The value of pre-emptive analgesia in the treatment of postoperative pain after laparoscopic cholecystectomy. Eur Surg Res 2001;33:39-41.
  • [22] Cantore F, Boni L, Di Giuseppe M, Giavarini L, Rovera F, Dionigi G. Pre-incision local infiltration with levobupivacaine reduces pain and analgesic consumption after laparoscopic cholecystectomy: a new device for day-case procedure. Int J Surg. 2008;6;89-92.
  • [23] Effectiveness of local anesthetics in laparoscopic cholecystectomy: a randomized clinical trial. Surg Laparosc Endosc Percutan Tech 2015;25:317-20.
  • [24] Hilvering B, Draaisma WA, vander Bilt JD, Valk RM, Kofman KE, Consten EC. Randomized clinical trial of combined preincional infiltration and intrperitoneal instillation of levobupivacaine for postoperative pain after laparoscopic cholcystectomy. Br J Surg 2011;98:784-9.
  • [25] Ingelmo PM, Bucciero M, Somaini M, Sahillioglu E, Garbagnati A, Charton A, et al. Intraperitoneal nebulization of ropivacaine for pain control after laparoscopic cholecystectomy: A double‐ blind, randomized, placebo‐controlled trial. Br J Anaesth 2013;110:800-6.
  • [26] Montroni I, Sabattini E, Ramadori E, Koprivica V, Ugolini G, Locatelli F, et al. Small bowel obstruction caused by a large B-cell lymphoma in a patient with multicentric Castleman’s disease: an unusual occurrence. Int J Surg Pathol 2014;22:434-7.
  • [27] Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer HJ, Cuschieri A, et al. The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc 2002;16:1121-43.
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Oğuz Uğur Aydın

Lütfi Soylu

Publication Date October 4, 2018
Submission Date October 19, 2017
Acceptance Date January 8, 2018
Published in Issue Year 2018 Volume: 4 Issue: 4

Cite

AMA Aydın OU, Soylu L. Impact of low-pressure pneumoperitoneum and local anesthetic combination on postoperative pain in patients undergoing laparoscopic cholecystectomy. Eur Res J. October 2018;4(4):326-332. doi:10.18621/eurj.345129

e-ISSN: 2149-3189 


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