Περίληψη:
Background. Laparoscopic cholecystectomy is the treatment of choice for
symptomatic cholelithiasis. Postoperative pain, however, can prolong
hospital stay and Lead to increased morbidity. In the context Of a
multimodal approach to analgesia, intraperitoneal local anesthetic
administration optimizes analgesia and facilitates early postoperative
recovery, and it may be associated with a decreased risk of side
effects.
Methods. A total of 71 patients was randomized to receive either
intraperitoneal analgesic (IPA group) or not (controls). At the
completion of cholecystectomy, 10 mL of levobupivacaine 0.5% were
infused intraperitoneally in the IPA group and 8 h postoperatively,
whereas in the controls, 10 mL of 0.9% NaCl were administered in the
corresponding points of time. Differences in pain scores between groups
were the primary endpoints. Opioid consumption and adverse effects were
the secondary endpoints.
Results. The 2 groups were homogenous in respect to age, sex, body mass
index (BMI), and duration of operation. No conversion, complication, or
mortality was recorded. The IPA group had a lesser visual analog scale
score at rest and at movement compared with controls at all points of
time measured. Moreover, fentanyl consumption in the recovery room was
significantly greater in the control group, and the consumption of
meperidine and the percentage of the patients that requested rescue
analgesia in the word was significantly greater in the control group.
Local analgesic intraperitoneal injection as well as Parecoxib for
Postoperative analgesia had no significant adverse effects.
Conclusion. Our study showed. that 2 separate doses of intraperitoneally
administered levobupivacaine significantly decreased postoperative pain
and the need for opioids compared with placebo. This technique is
simple, safe, and without adverse effects. (Surgery 2009;146:475-82.)
Συγγραφείς:
Papadima, Artemisia
Lagoudianakis, Emmanuel E.
Antonakis,
Pantelis
Filis, Konstantinos
Makri, Ira
Markogiannakis,
Haridimos
Katergiannakis, Vaggelogiannis
Manouras, Andreas
