Skip to main content
Top
Published in: World Journal of Surgery 8/2004

01-08-2004 | Original Scientific Reports

Local Anesthesia Use for Laparoscopic Cholecystectomy

Authors: Aydin Inan, M.D., Meral Sen, M.D., Cenap Dener, M.D.

Published in: World Journal of Surgery | Issue 8/2004

Login to get access

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.
Literature
1.
go back to reference McKernan, JB, Champion, JK 1995Access techniques: Veress needle—initial blind trocar insertion versus open laparoscopy with the Hasson trocarEndosc. Surg. Allied Technol.335PubMed McKernan, JB, Champion, JK 1995Access techniques: Veress needle—initial blind trocar insertion versus open laparoscopy with the Hasson trocarEndosc. Surg. Allied Technol.335PubMed
2.
go back to reference Ballem, RV, Rudomanski, J 1993Techniques of pneumoperitoneumSurg. Laparosc. Endosc.342PubMed Ballem, RV, Rudomanski, J 1993Techniques of pneumoperitoneumSurg. Laparosc. Endosc.342PubMed
3.
4.
go back to reference Rademaker, BM, Kalkman, CJ, Odoom, JA, et al. 1994Intraperitoneal local anaesthetics after laparoscopic cholecystectomy: effects on postoperative pain, metabolic responses and lung functionBr. J. Anaesth.72263PubMed Rademaker, BM, Kalkman, CJ, Odoom, JA,  et al. 1994Intraperitoneal local anaesthetics after laparoscopic cholecystectomy: effects on postoperative pain, metabolic responses and lung functionBr. J. Anaesth.72263PubMed
5.
go back to reference Lee, IO, Kim, SH, Kong, MH, et al. 2001Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaineCan. J. Anaesth.48545PubMed Lee, IO, Kim, SH, Kong, MH,  et al. 2001Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaineCan. J. Anaesth.48545PubMed
6.
go back to reference Alexander, DJ, Ngoi, SS, Lee, L, et al. 1996Randomized trial of periportal peritoneal bupivacaine for pain relief after laparoscopic cholecystectomyBr. J. Surg.831223CrossRefPubMed Alexander, DJ, Ngoi, SS, Lee, L,  et al. 1996Randomized trial of periportal peritoneal bupivacaine for pain relief after laparoscopic cholecystectomyBr. J. Surg.831223CrossRefPubMed
7.
go back to reference Bisgaard, T, Klarskov, B, Kristiansen, VB, et al. 1999Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled studyAnesth. Analg.891017PubMed Bisgaard, T, Klarskov, B, Kristiansen, VB,  et al. 1999Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled studyAnesth. Analg.891017PubMed
8.
go back to reference Chundrigar, T, Morris, R, Hedges, AR, et al. 1993Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomyAnn. R. Coll. Surg. Engl.75437PubMed Chundrigar, T, Morris, R, Hedges, AR,  et al. 1993Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomyAnn. R. Coll. Surg. Engl.75437PubMed
9.
go back to reference Scott, ADN, Greville, AC, McMillan, L, et al. 1992Laparoscopic laser cholecystectomy: results of the technique in 210 patientsAnn. R. Coll. Surg. Engl.74237PubMed Scott, ADN, Greville, AC, McMillan, L,  et al. 1992Laparoscopic laser cholecystectomy: results of the technique in 210 patientsAnn. R. Coll. Surg. Engl.74237PubMed
10.
go back to reference Lord, McC 1992Laparoscopic cholecystectomyAnn. R. Coll. Surg. Engl.74231PubMed Lord, McC 1992Laparoscopic cholecystectomyAnn. R. Coll. Surg. Engl.74231PubMed
11.
go back to reference Rees, BI, Williams, HR 1992Laparoscopic cholecystectomy: the first 155 patientsAnn. R. Coll. Surg. Engl.74233PubMed Rees, BI, Williams, HR 1992Laparoscopic cholecystectomy: the first 155 patientsAnn. R. Coll. Surg. Engl.74233PubMed
12.
go back to reference Gadacz, TR 2000Update on laparoscopic cholecystectomy, including a clinical pathwaySurg. Clin. North Am.801127PubMed Gadacz, TR 2000Update on laparoscopic cholecystectomy, including a clinical pathwaySurg. Clin. North Am.801127PubMed
13.
go back to reference Coda, A, Bossotti, M, Feri, F, et al. 2000Incisional hernia and fascial defect following laparoscopic surgerySurg. Laparosc. Endosc. Percutan. Tech.1034CrossRefPubMed Coda, A, Bossotti, M, Feri, F,  et al. 2000Incisional hernia and fascial defect following laparoscopic surgerySurg. Laparosc. Endosc. Percutan. Tech.1034CrossRefPubMed
14.
go back to reference Motamed, C, Bouaziz, H, Franco, D, et al. 2000Analgesic effect of low-dose intrathecal morphine and bupivacaine in laparoscopic cholecystectomyAnaesthesiology55118CrossRef Motamed, C, Bouaziz, H, Franco, D,  et al. 2000Analgesic effect of low-dose intrathecal morphine and bupivacaine in laparoscopic cholecystectomyAnaesthesiology55118CrossRef
15.
go back to reference Ure, BM, Troidl, H, Spanberger, W, et al. 1993Preincisional local anesthesia with bupivacaine and pain after laparoscopic cholecystectomy: a double-blind randomized clinical trialSurg. Endosc.7482PubMed Ure, BM, Troidl, H, Spanberger, W,  et al. 1993Preincisional local anesthesia with bupivacaine and pain after laparoscopic cholecystectomy: a double-blind randomized clinical trialSurg. Endosc.7482PubMed
16.
go back to reference Gharaibeh, KI, Al-Jaberi, TM 2000Bupivacaine instillation into gallbladder bed after laparoscopic cholecystectomy: does it decrease shoulder pain?J. Laparoendosc. Adv. Surg. Tech.10137 Gharaibeh, KI, Al-Jaberi, TM 2000Bupivacaine instillation into gallbladder bed after laparoscopic cholecystectomy: does it decrease shoulder pain?J. Laparoendosc. Adv. Surg. Tech.10137
17.
go back to reference Hall, GM, Desborough, JP 1992Interleukin-6 and the metabolic response to surgeryBr. J. Anesth.69337 Hall, GM, Desborough, JP 1992Interleukin-6 and the metabolic response to surgeryBr. J. Anesth.69337
18.
go back to reference Sarac, AM, Aktan, AO, Baykan, N, et al. 1996The effect of timing of local anaesthesia in laparoscopic cholecystectomySurg. Laparosc. Endosc.6362CrossRefPubMed Sarac, AM, Aktan, AO, Baykan, N,  et al. 1996The effect of timing of local anaesthesia in laparoscopic cholecystectomySurg. Laparosc. Endosc.6362CrossRefPubMed
19.
go back to reference Szem, JW, Hydo, L, Barie, PS 1996A double-blinded evaluation of intraperitoneal bupivacaine vs. saline for reduction of postoperative pain and nausea after laparoscopic cholecystectomySurg. Endosc.1044CrossRefPubMed Szem, JW, Hydo, L, Barie, PS 1996A double-blinded evaluation of intraperitoneal bupivacaine vs. saline for reduction of postoperative pain and nausea after laparoscopic cholecystectomySurg. Endosc.1044CrossRefPubMed
20.
go back to reference Chundrigar, T, Morris, R, Hedges, AR, et al. 1993Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomyAnn. R. Coll. Surg. Engl.75437PubMed Chundrigar, T, Morris, R, Hedges, AR,  et al. 1993Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomyAnn. R. Coll. Surg. Engl.75437PubMed
21.
go back to reference Helvacioglu, A, Weis, R 1992Operative laparoscopy and postoperative pain reliefFertil. Steril.57548PubMed Helvacioglu, A, Weis, R 1992Operative laparoscopy and postoperative pain reliefFertil. Steril.57548PubMed
22.
go back to reference Goegler, S, Blobner, M, Busley, R, et al. 1993Subphrenic catheter for postoperative analgesia after laparoscopic cholecystectomyAnaesthesiology79A26 Goegler, S, Blobner, M, Busley, R,  et al. 1993Subphrenic catheter for postoperative analgesia after laparoscopic cholecystectomyAnaesthesiology79A26
23.
go back to reference Narchi, P, Benhamou, D, Fernandez, H 1991Intraperitoneal local anaesthetic for shoulder pain after day-case laparoscopyLancet3381569CrossRefPubMed Narchi, P, Benhamou, D, Fernandez, H 1991Intraperitoneal local anaesthetic for shoulder pain after day-case laparoscopyLancet3381569CrossRefPubMed
24.
go back to reference Mraovic, B, Jurisic, T, Majeric, VK, et al. 1997Intraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomyActa Anesthesiol. Scand.41193 Mraovic, B, Jurisic, T, Majeric, VK,  et al. 1997Intraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomyActa Anesthesiol. Scand.41193
25.
go back to reference Smith, BE, Suchak, M, Siggins, D, et al. 1988Rectus sheath block for diagnostic laparoscopyAnaesthesiology43947 Smith, BE, Suchak, M, Siggins, D,  et al. 1988Rectus sheath block for diagnostic laparoscopyAnaesthesiology43947
26.
go back to reference Shoulte-Steinberg, H, Weninger, E, Jokisch, D, et al. 1995Intraperitoneal versus interpleural morphine or bupivacaine for pain after laparoscopic cholecystectomyAnesthesiology82634CrossRefPubMed Shoulte-Steinberg, H, Weninger, E, Jokisch, D,  et al. 1995Intraperitoneal versus interpleural morphine or bupivacaine for pain after laparoscopic cholecystectomyAnesthesiology82634CrossRefPubMed
27.
go back to reference Cox, B, Durieux, ME, Marcus, MA 2003Toxicity of local anaestheticsBest Pract. Res. Clin. Anaesthesiol.17111CrossRefPubMed Cox, B, Durieux, ME, Marcus, MA 2003Toxicity of local anaestheticsBest Pract. Res. Clin. Anaesthesiol.17111CrossRefPubMed
28.
go back to reference Pasqualucci, A, Angelis, VD, Contardo, R, et al. 1996Preemptive analgesia: intraperitoneal local anesthetic in laparoscopic cholecystectomyAnesthesiology8511CrossRefPubMed Pasqualucci, A, Angelis, VD, Contardo, R,  et al. 1996Preemptive analgesia: intraperitoneal local anesthetic in laparoscopic cholecystectomyAnesthesiology8511CrossRefPubMed
29.
go back to reference Bourget, JL, Clark, J, Joy, N 1997Comparing preincisional with postincisional bupivacaine infiltration in the management of postoperative painArch. Surg.132766PubMed Bourget, JL, Clark, J, Joy, N 1997Comparing preincisional with postincisional bupivacaine infiltration in the management of postoperative painArch. Surg.132766PubMed
30.
go back to reference Pasqualucci, A 1998Experimental and clinical studies about the preemptive analgesia with local anaesthetics: possible reasons of the failureMinerva Anestesiol.64445PubMed Pasqualucci, A 1998Experimental and clinical studies about the preemptive analgesia with local anaesthetics: possible reasons of the failureMinerva Anestesiol.64445PubMed
31.
go back to reference Ke, RW, Portera, SG, Bagous, W, et al. 1998A randomised, double blinded trial of preemptive analgesia in laparoscopyObstet. Gynecol.92972CrossRefPubMed Ke, RW, Portera, SG, Bagous, W,  et al. 1998A randomised, double blinded trial of preemptive analgesia in laparoscopyObstet. Gynecol.92972CrossRefPubMed
Metadata
Title
Local Anesthesia Use for Laparoscopic Cholecystectomy
Authors
Aydin Inan, M.D.
Meral Sen, M.D.
Cenap Dener, M.D.
Publication date
01-08-2004
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 8/2004
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-004-7350-3

Other articles of this Issue 8/2004

World Journal of Surgery 8/2004 Go to the issue