Abstract
BackgroundLaparoscopic cholecystectomy (LC) has become the treatment of choice for gallbladder lesions, but it is not a pain-free procedure. This study explored the pain relief provided by combined wound and intraperitoneal local anesthetic use for patients who are undergoing LC.MethodsTwo-hundred and twenty consecutive patients undergoing LC were categorized into 1 of the following 4 groups: local wound anesthetic after LC either with an intraperitoneal local anesthetic (W + P) (group 1) or without an intraperitoneal local anesthetic (W + NP) (group 2), or no local wound anesthetic after LC either with intraperitoneal local anesthetic (NW + P) (group 3) or without an intraperitoneal local anesthetic (NW + NP) (group 4). A visual analog scale (VAS) was used to assess postoperative pain. The amount of analgesic used and the duration of hospital stay were also recorded.ResultsThe VAS was significantly lower immediately after LC for the W + P group than for the NW + NP group (5 vs. 6; p = 0.012). Patients in the W + P group received a lower total amount of meperidine during their hospital stay. They also had the shortest hospital stay after LC, compared to the patients in the other groups.ConclusionCombined wound and intraperitoneal local anesthetic use after LC significantly decreased the immediate postoperative pain and may explain the reduced use of meperidine and earlier discharge of patients so treated.
Highlights
Laparoscopic cholecystectomy (LC) has become the treatment of choice for gallbladder lesions, but it is not a pain-free procedure
Laparoscopic cholecystectomy is the treatment of choice for a wide spectrum of gallbladder diseases [7,8,9,10]
The relief of pain resulting from combined wound and intraperitoneal local anesthetics for patients undergoing LC has been evaluated [21]; the treatment still needs a full evaluation because of a limited number of patients and inappropriate use of intraperitoneal local anesthetics in the previous study [21]
Summary
Laparoscopic cholecystectomy (LC) has become the treatment of choice for gallbladder lesions, but it is not a pain-free procedure. Since 1987, laparoscopic cholecystectomy (LC) has become the standard procedure for the treatment of gallbladder lesions Increased experience with this technique has altered some of the previous contraindications for LC such as patients with end-stage renal disease, liver cirrhosis, and severe cardiovascular disease [1,2,3]. A major benefit of using laparoscopy for upper gastrointestinal surgery is that it avoids an upper abdominal incision Such incisions hinder postoperative pulmonary rehabilitation, cause surgical wound pain, and increase the total medical cost [4,5,6]. The relief of pain resulting from combined wound and intraperitoneal local anesthetics for patients undergoing LC has been evaluated [21]; the treatment still needs a full evaluation because of a limited number of patients and inappropriate use of intraperitoneal local anesthetics in the previous study [21]. In this prospective case-controlled study, we clarified the impact of combined wound and intraperitoneal local anesthetic use on pain relief in patients who underwent LC
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