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 .
Pain after microlaparoscopic cholecystectomy. A randomized double-blind controlled study.
BACKGROUND Laparoscopic cholecystectomy ( LC ) is traditionally performed with two 10-mm and two 5-mm trocars . The effect of smaller port incisions on pain has not been established in controlled studies . METHODS In a double-blind controlled study , patients were r and omized to LC or cholecystectomy with three 2-mm trocars and one 10-mm trocar ( micro-LC ) .  All patients received a multimodal analgesic regimen , including incisional local anesthetics at the beginning of surgery , NSAID , and paracetamol .  Pain was registered preoperatively , for the first 3 h postoperatively , and daily for the 1st week . RESULTS The study was discontinued after inclusion of 26 patients because five of the 13 patients ( 38 % ) r and omized to micro-LC were converted to LC . In the remaining 21 patients , overall pain and incisional pain intensity during the first 3 h postoperatively increased in the LC group ( n = 13 ) compared with preoperative pain levels ( p<0.01 ) , whereas pain did not increase in the micro-LC group ( n = 8) . CONCLUSIONS Micro-LC in combination with a prophylactic multimodal analgesic regimen reduced postoperative pain for the first 3 h postoperatively . However , the micro-LC led to an unacceptable rate of conversion to LC ( 38 % ) . The micro-LC instruments therefore need further technical development before this surgical technique can be used on a routine basis for 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 .