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 .
The Clinical Efficacy and Pharmacokinetics of Intraperitoneal Ropivacaine for Laparoscopic Cholecystectomy
Postoperative pain after laparoscopic surgery is less than after laparotomy , and patients may benefit from an intraperitoneal injection of local anesthetic .  Thirty-seven ASA physical status I or II patients received in double-blinded fashion 20 mL of 0.9 % saline solution ( placebo ) , ropivacaine 0.25 % ( Rop 0.25 % ) , or ropivacaine 0.75 % ( Rop 0.75 % ) immediately after trocar placement and at the end of surgery . We measured pain and morphine consumption until 20 h after surgery . Plasma ropivacaine concentrations were measured . The three groups were comparable for shoulder pain , parietal pain , and incidence of side effects . Visceral pain at rest , during cough , and on movement and total consumption of morphine were significantly smaller in Groups Rop 0.25 % and Rop 0.75 % when compared with Placebo . Although no adverse effect occurred in any patient , the largest dose led to large plasma concentrations of ropivacaine  ( 2.93 ± 2.46 & mgr;g/mL and 3.76 ± 3.01 & mgr;g/mL after the first and second injection , respectively ) . We conclude that intraperitoneal administration of ropivacaine before and after surgery significantly decreases postoperative pain . Because the smaller dosage ( 2 × 50 mg ) provided similar analgesia and was associated with significantly smaller plasma concentrations than the larger dosage ( 2 × 150 mg ) , this smaller dosage seems more appropriate
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 .