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 .
Effect of intraperitoneal bupivacaine on pain after laparoscopic cholecystectomy
The effect of intraperitoneal bupivacaine on postoperative pain was studied in 60 ASA 1–2 patients undergoing elective laparoscopic cholecystectomy . The patients were r and omly selected ( 20 patients in each group ) to receive in double‐blind fashion 100 ml of either plain 0.15 % bupivacaine { 150 mg · 100 ml‐1 ) or the same solution with adrenaline ( 1.5 μg ml‐l ) , or the same volume of saline into the right subdiaphragmatic space at the end of surgery . The patients were kept in the Trendelenburg 's position for 20 min after the instillation . Venous blood sample s for the determination of bupivacaine plasma concentrations were drawn up to 180 min . Plasma bupivacaine concentrations peaked at 30 min ( highest individual value 2.6 μg ml‐1 ) after instillation . Bupivacaine concentrations were significantly lower in the bupivacaine‐adrenaline group . During the follow‐up no difference between the groups occurred as to the time to first dem and of analgesia , severity of postoperative pain , amount of consumed analgesics during 7 days , and length of hospitalization . In all groups , 30–45 % of the patients complained of right shoulder pain . After the first 24 hours , pain at rest and during moving was reported as mild and was managed with oral ketoprofen
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 .