Randomized clinical trial of the influence of intraperitoneal local anaesthesia on pain after laparoscopic surgery
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Randomized clinical trial of the influence of intraperitoneal local anaesthesia on pain after laparoscopic surgery. / Palmes, D; Röttgermann, S; Classen, C; Haier, J; Horstmann, R.
In: BRIT J SURG, Vol. 94, No. 7, 07.2007, p. 824-32.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Randomized clinical trial of the influence of intraperitoneal local anaesthesia on pain after laparoscopic surgery
AU - Palmes, D
AU - Röttgermann, S
AU - Classen, C
AU - Haier, J
AU - Horstmann, R
N1 - Copyright (c) 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
PY - 2007/7
Y1 - 2007/7
N2 - BACKGROUND: There is controversy about the effectiveness of intraperitoneal local anaesthesia (LA) in laparoscopic surgery. The aim of the present randomized clinical trial was to compare the analgesic effect of pre-emptive (preoperative) versus postoperative intraperitoneal LA in two different types of laparoscopic surgery.METHODS: Between July 2004 and January 2005, 133 consecutive patients scheduled to undergo laparoscopic fundoplication or hernia repair were randomly assigned to one of three treatments: placebo solution (50 ml 0.9 per cent saline) or LA (50 ml 0.5 per cent lidocaine) administered immediately after creation of the pneumoperitoneum, or LA (50 ml 0.5 per cent lidocaine) at the end of the operation. Analgesic requirements were analysed, and pain was assessed using a visual analogue scale (VAS) from 0 to 100 at 6, 12, 24 and 48 h after surgery.RESULTS: The duration of pneumoperitoneum (median 66 versus 46 min respectively; P < 0.001) and overall pain intensity (median VAS score 46.7 versus 6.5; P < 0.001) were higher for laparoscopic fundoplication than for hernia repair. Preoperative application of LA reduced abdominal pain (median 28.6 versus 74.9; P < 0.005), shoulder pain (median 24.3 versus 43.8; P = 0.004) and analgesic consumption (mean(s.d.) 11.1(5.0) versus 18.5(5.4) mg piritramide per 48 h; P = 0.002) after fundoplication, but had no analgesic effects after hernia repair.CONCLUSION: Pre-emptive application of LA reduced postoperative pain and analgesic requirements after laparoscopic fundoplication.
AB - BACKGROUND: There is controversy about the effectiveness of intraperitoneal local anaesthesia (LA) in laparoscopic surgery. The aim of the present randomized clinical trial was to compare the analgesic effect of pre-emptive (preoperative) versus postoperative intraperitoneal LA in two different types of laparoscopic surgery.METHODS: Between July 2004 and January 2005, 133 consecutive patients scheduled to undergo laparoscopic fundoplication or hernia repair were randomly assigned to one of three treatments: placebo solution (50 ml 0.9 per cent saline) or LA (50 ml 0.5 per cent lidocaine) administered immediately after creation of the pneumoperitoneum, or LA (50 ml 0.5 per cent lidocaine) at the end of the operation. Analgesic requirements were analysed, and pain was assessed using a visual analogue scale (VAS) from 0 to 100 at 6, 12, 24 and 48 h after surgery.RESULTS: The duration of pneumoperitoneum (median 66 versus 46 min respectively; P < 0.001) and overall pain intensity (median VAS score 46.7 versus 6.5; P < 0.001) were higher for laparoscopic fundoplication than for hernia repair. Preoperative application of LA reduced abdominal pain (median 28.6 versus 74.9; P < 0.005), shoulder pain (median 24.3 versus 43.8; P = 0.004) and analgesic consumption (mean(s.d.) 11.1(5.0) versus 18.5(5.4) mg piritramide per 48 h; P = 0.002) after fundoplication, but had no analgesic effects after hernia repair.CONCLUSION: Pre-emptive application of LA reduced postoperative pain and analgesic requirements after laparoscopic fundoplication.
KW - Administration, Topical
KW - Adult
KW - Aged
KW - Analgesics
KW - Anesthesia, General
KW - Anesthesia, Local
KW - Female
KW - Fundoplication
KW - Gastroesophageal Reflux
KW - Herniorrhaphy
KW - Humans
KW - Laparoscopy
KW - Male
KW - Middle Aged
KW - Pain Measurement
KW - Pain, Postoperative
KW - Pneumoperitoneum, Artificial
KW - Preoperative Care
KW - Shoulder Pain
KW - Treatment Outcome
U2 - 10.1002/bjs.5810
DO - 10.1002/bjs.5810
M3 - SCORING: Journal article
C2 - 17571296
VL - 94
SP - 824
EP - 832
JO - BRIT J SURG
JF - BRIT J SURG
SN - 0007-1323
IS - 7
ER -