The Effect of Intraperitoneal Instillation and Trocar Site Infiltration of 0.25% Levobupivacaine on the Postoperative Pain after Performing Laparoscopic Cholecystectomy under Remifentanil Based Anesthesia.
- Author:
Cheol LEE
1
;
Yoon Kang SONG
Author Information
- Publication Type:Original Article
- Keywords: laparoscopic cholecystectomy; levobupivacaine; postoperative pain; remifentanil
- MeSH: Analgesics; Analgesics, Opioid; Anesthesia; Anesthesia, General; Anesthetics, Local; Bupivacaine; Cholecystectomy, Laparoscopic; Humans; Hypogonadism; Methyl Ethers; Mitochondrial Diseases; Ophthalmoplegia; Pain, Postoperative; Piperidines; Surgical Instruments; Urinary Bladder
- From:The Korean Journal of Pain 2008;21(1):44-50
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND: The use of regional local anesthetics or opioids during laparoscopic cholecystectomy (LC), in combination with general anesthesia, has been investigated in several interventional studies. METHODS: We studied a total of 240 (n = 60, each) patients who were undergoing LC, and they received local infiltration and intraperitoneal instillation with normal saline or 0.25% levobupivacaine 60 ml. Group R (S) received infiltration of normal saline 20 ml before incision and at the end of surgery and then 40 ml intraperitoneal instillation after removal of the gall bladder under remifentanil-based anesthesia. Group R (L) received 0.25% levobupivacaine instead of normal saline in the same method like group R (S). Group S (S) received the same method as group R (S) under sevoflurane based anesthesia in place of remifentanil. Group S (L) received 0.25% levobupivacaine instead of normal saline with the same method as group S (S). Pain was assessed on a visual analog scale at 1, 6, 12 and 24 hours after operation. RESULTS: The pain intensity of Group R (L) was significantly lower than that of group R (S), and the the incisional pain of group S (L) was significantly lower than that of group S (S) in the first six hours. The time delay to first operative analgesics in group R (S) and group S (S) was significantly shorter than that of group R (L) and group S (L). CONCLUSIONS: Infiltration and instillation of levobupivacaine reduced the postoperative pain and remifentanil did not increase the pain severity and opioid requirement when performing the LC.
