Local Anesthetic Nebulization for Pain Control After Laparoscopic Cholecystectomy
Condition: Laparoscopic Cholecystectomy
Study type: Interventional
Phase: Phase 3

Summary: 
      Intraperitoneal nebulization of local anesthetic is a novel approach to pain management after
      laparoscopy. Preoperative compared with postoperative administration of analgesia remains
      controversial. This randomized, double blind, placebo-controlled trial compared the analgesic
      efficacy of preoperative with postoperative peritoneal ropivacaine nebulization in patients
      undergoing elective laparoscopic cholecystectomy.
    

Detailed description: 
      Previous studies evaluating intraperitoneal local anesthetic administration for pain relief
      after laparoscopic surgery have suggested that the timing of local anesthetic administration
      may be critical in the success of the technique. A meta-analysis of randomized trials of
      intraperitoneal local anesthetic instillation in patients undergoing laparoscopic surgery
      found that local anesthetic instilled before surgical dissection provided superior pain
      relief compared to instillation at the end of surgery. Intraperitoneal nebulization of local
      anesthetic is a novel approach to pain management after laparoscopic surgery. Recently,
      Alkhamesi et al reported that bupivacaine nebulization performed at the end of laparoscopic
      cholecystectomy significantly reduced postoperative pain. However, clinical benefits of
      preoperative administration of analgesia, compared with postoperative administration, remains
      controversial.

      The investigators hypothesized that pain relief after preoperative and postoperative
      ropivacaine nebulization would be similar but better than placebo.
    

Intervention name(s): Ropivacaine 30 mg; Ropivacaine 30 mg; Saline
Intervention type(s): Drug; Drug; Drug
Intervention description(s): Intraperitoneal nebulization of ropivacaine 1% 3 ml (30 mg) before surgery and intraperitoneal nebulization of normal saline 3 ml after surgery.
Nebulization was performed over 5-10 minutes using the Aeroneb Pro® device through the umbilical port during the insertion of the other ports, while postoperative nebulization was performed before the withdrawal of the ports.; intraperitoneal Nebulization of normal saline 3 ml before surgery and intraperitoneal nebulization of ropivacaine 1% 3 ml (30 mg) after surgery.
Nebulization was performed over 5-10 minutes using the Aeroneb Pro® device through the umbilical port during the insertion of the other ports, while postoperative nebulization was performed before the withdrawal of the ports.; Intraperitoneal nebulization of normal saline 3 ml before and after surgery. Nebulization was performed over 5-10 minutes using the Aeroneb Pro® device through the umbilical port during the insertion of the other ports, while postoperative nebulization was performed before the withdrawal of the ports.
Intervention MeSH terms: Ropivacaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Laparoscopic Cholecystectomy; Nebulization; Ropivacaine