Fakhroddin Kiany1, Seyed Mostafa Meshkati Yazd1, Reza Shahriarirad2, Hooman Kamran2,3, Mohammadreza Karoobi4, Nafiseh Shabani Mofrad5, Mohammad Kamali6. 1. Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. 2. Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 3. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. 4. Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Mr.karoobi@gmail.com. 5. Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 6. Department of Surgery, Arak University of Medical Sciences, Arak, Iran.
Abstract
PURPOSE: The efficacy of intraperitoneal (IP) and incisional use of local anesthesia in laparoscopic cholecystectomy is a promising subject regarding post-operative pain control. In this study, we aim to compare these methods using lidocaine as the local anesthetic. METHODS: This study was a double-blinded randomized controlled trial. Eighty-two patients, candidates for laparoscopic cholecystectomy, were included. Participants were randomly divided into two equal groups; the instillation group and the infiltration group. In the instillation group, a 2% lidocaine ampule was instilled in the gallbladder bed after removal of the gallbladder. In the infiltration group, a 2% lidocaine ampule was injected subcutaneously into the port sites before making the incisions for the insertion of laparoscopic ports. RESULTS: The mean age of patients were 41.66 ± 14.44 and 48.05 ± 17.03 years in the instillation and infiltration groups, respectively. The etiologies recorded in this study were: acute calculous cholecystitis (29.3%), symptomatic gallstone (68.3%), and polyp (2.4). The pain severity, evaluated at six different times, from immediately after awakening from anesthesia to 24 h after the operation, was not significantly different between the two groups (p-value = 0.329). Consumption of nonsteroidal anti-inflammatory drugs and narcotics, were statistically lower in the instillation group (p-value = 0.013 and 0.003, respectively). However, hospitalization period, time spent to return to normal bowel movements and oral diet, and postoperative nausea/vomiting were not significantly significant between the groups. CONCLUSION: IP instillation of lidocaine following laparoscopic cholecystectomy offers post-operative pain relief and is associated with lower analgesic consumption in comparison to subcutaneous injection of this agent at the port site.
PURPOSE: The efficacy of intraperitoneal (IP) and incisional use of local anesthesia in laparoscopic cholecystectomy is a promising subject regarding post-operative pain control. In this study, we aim to compare these methods using lidocaine as the local anesthetic. METHODS: This study was a double-blinded randomized controlled trial. Eighty-two patients, candidates for laparoscopic cholecystectomy, were included. Participants were randomly divided into two equal groups; the instillation group and the infiltration group. In the instillation group, a 2% lidocaine ampule was instilled in the gallbladder bed after removal of the gallbladder. In the infiltration group, a 2% lidocaine ampule was injected subcutaneously into the port sites before making the incisions for the insertion of laparoscopic ports. RESULTS: The mean age of patients were 41.66 ± 14.44 and 48.05 ± 17.03 years in the instillation and infiltration groups, respectively. The etiologies recorded in this study were: acute calculous cholecystitis (29.3%), symptomatic gallstone (68.3%), and polyp (2.4). The pain severity, evaluated at six different times, from immediately after awakening from anesthesia to 24 h after the operation, was not significantly different between the two groups (p-value = 0.329). Consumption of nonsteroidal anti-inflammatory drugs and narcotics, were statistically lower in the instillation group (p-value = 0.013 and 0.003, respectively). However, hospitalization period, time spent to return to normal bowel movements and oral diet, and postoperative nausea/vomiting were not significantly significant between the groups. CONCLUSION: IP instillation of lidocaine following laparoscopic cholecystectomy offers post-operative pain relief and is associated with lower analgesic consumption in comparison to subcutaneous injection of this agent at the port site.
Authors: Se Hun Lim; Eun Ho Jang; Myoung-Hun Kim; Kwangrae Cho; Jeong Han Lee; Kun Moo Lee; Soon Ho Cheong; Young-Jae Kim; Chee-Mahn Shin Journal: Korean J Anesthesiol Date: 2011-10-22
Authors: J Bueno Lledó; M Planells Roig; C Arnau Bertomeu; A Sanahuja Santafé; M Oviedo Bravo; R García Espinosa; R Martí Obiol; A Espí Salinas Journal: Rev Esp Enferm Dig Date: 2006-01 Impact factor: 2.086