Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine
- Authors
- Lee, IO; Kim, SH; Kong, MH; Lee, MK; Kim, NS; Choi, YS; Lim, SH
- Issue Date
- 6월-2001
- Publisher
- CANADIAN ANESTHESIOLOGISTS SOC
- Keywords
- 마취
- Citation
- CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, v.48, no.6, pp.545 - 550
- Indexed
- SCIE
SCOPUS
- Journal Title
- CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
- Volume
- 48
- Number
- 6
- Start Page
- 545
- End Page
- 550
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/124395
- DOI
- 10.1007/BF03016830
- ISSN
- 0832-610X
- Abstract
- Purpose: To examine the combined preemptive effects of somatovisceral blockade during laparoscopic cholecystectomy (LC). Methods: One hundred fifty-seven patients under general anes thesia receiving local infiltration and/or topical peritoneal local anesthesia were studied. Patients were randomized to receive a total of 150 mg (0.25% 60 mL) bupivacaine via periportal (20 mL) and intraperitoneal (40 mL with 1:200,000 epinephrine) administration of each. Group A received preoperative periportal bupivacaine before incision and intraperitoneal bupivacaine immediately after the pneumoperitoneum. Group B received periportal and intraperitoneal bupivacaine at the end of the operation. Group C (preoperative) and Group D (postoperative) received only periportal bupivacaine and Group E (preoperative) and Group F (postoperative) received only intraperitoneal bupivacaine. The control group received no treatment. Pain and nausea were recorded at one, two, three, six, nine, 12, 24, 36, and 48 hr postoperatively. Results: Throughout the postoperative 48 hr, incisional somatic pain dominated over other pain localizations in the control group (P <0.05). The incisional pain of groups A, B, C and D was significantly lower than that of the control group in the first and second hours. The incisional pain of groups A and C was significantly lower than that of the control group in the first three hours. Conclusion: Incisional pain dominated during the first two postoperative days after LC. Preoperative somato-visceral or somatic local anesthesia reduced incisional pain during the first three postoperative hours. A combination of somato-visceral local anesthetic treatment did not reduce intraabdominal pain, shoulder pain or nausea more than somatic treatment alone. Preoperative incisional infiltration of local anesthetics is recommended.
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