This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .
Randomized trial of periportal peritoneal bupivacaine for pain relief after laparoscopic cholecystectomy
The aim of this study was to determine whether injection of a long‐acting local anaesthetic , in relation to the port sites at the level of the parietal peritoneum , would reduce postoperative pain following laparoscopic cholecystectomy . Patients were entered into a r and omized , prospect i ve , double‐blind study comparing the effects of a st and ard technique , in which bupivacaine ( total of 20 ml , 0–5 per cent ) was injected into the subcutaneous periportal tissue around the four port sites , and a technique in which bupivacaine ( total of 20 ml , 0.25 per cent ) was injected into the subcutaneous periportal tissue as above with the addition of periportal parietal peritoneal injection of bupivacaine ( total of 20 ml , 0–25 per cent ) . Two scores for pain , with the patient at rest , and on movement , were assessed 6 and 18 h after surgery using a visual analogue pain scale . Median pain score was significantly higher in patients who received st and ard technique ( n = 40 ) than in those given peritoneal injection ( n = 40 ) at both 6 ( rest = 3.0 versus 1.0 , movement = 5.0 versus 2.9 ) and 18 h ( rest = 1.9 versus 0 , movement = 3.2 versus 1.2 ) . Both opiate and oral analgesic requirements were reduced in patients administered peritoneal injection , although this was not statistically significant . The addition of periportal injection of bupivacaine at the level of the parietal peritoneum , performed under direct vision , reduces pain after laparoscopic cholecystectomy
This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .