Impact of low-pressure pneumoperitoneum and local anesthetic combination on postoperative pain in patients undergoing laparoscopic cholecystectomy

Year 2018, Volume: 4 Issue: 4, 326 - 332, 04.10.2018

Oğuz Uğur Aydın , Lütfi Soylu

https://doi.org/10.18621/eurj.345129

Cited By: 3

Abstract

Objectives: Despite the advantages of laparoscopic cholecystectomy
(LC), postoperative pain remains a
major complaint for many patients. In this study, in patients undergoing LC, the application of LC
via incisional
bupivacaine and low inflation pressure, alone or combined, and a comparison of
the effects on postoperative pain has been purposed.

Methods: Patients were randomly
assigned into the following 4 groups: the standard pressure (SP) group (n =
30); patients with an intraabdominal insufflation pressure of 12 mmHg, where
bupivacaine application was not performed at the trocar locations. The SP+local anesthetic (LA) (SP+LA) group (n =
30); patients with an intraabdominal insufflation pressure of 12 mmHg, where bupivacaine
application was performed at the trocar locations. The low pressure (LP) group
(n = 30); patients with an intraabdominal insufflation pressure of 8 mmHg, where bupivacaine application was not
performed at the trocar locations. The (LP+LA) group (n = 30); patients with an
intraabdominal insufflation pressure of 8 mmHg, where bupivacaine
application was performed at the trocar locations.
Postoperative pain was evaluated using the visual analogous scale (VAS).

Results: When the relationships
between the VAS scores, gender, age, and American Society of Anesthesiologists
classification were evaluated, no significant relationships
between the groups were observed (p
> 0.05). A significant relationship between the groups was detected with
regards to the VAS scores, 1^st analgesic application, 2^nd
analgesic application, and patients’ satisfaction (p < 0.05).

Conclusions: The combination of low
insufflation pressure with intrafacial preincisional local anesthetic
infiltration in post-LC pain palliation is thought to be more effective and
applicable. 

Keywords

Laparoscopic cholecystectomy, local anesthetic, low pressure

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