Cargando…

Comparison of Trocar Site versus Trocar Site Plus Intraperitoneal Instillation of Local Anesthetic for Shoulder Pain Following Laparoscopic Abdominal Surgery

BACKGROUND: Laparoscopic surgery in recent times has noteworthy advantages over conventional surgery, yet recovery is prolonged due to debilitating shoulder tip pain (STP) and operated site pain. Various studies have compared the effect of trocar site, intraperitoneal instillation of local anestheti...

Descripción completa

Detalles Bibliográficos
Autores principales: Lysander, Sheerin Sarah, Kumar, G. Dilip, Balasubramanian, Anusha, Krishnan, Rajarajeswaran, Raghuraman, M. S., Narayanan, S. Vijay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004265/
https://www.ncbi.nlm.nih.gov/pubmed/35422541
http://dx.doi.org/10.4103/aer.aer_156_21
_version_ 1784686251773788160
author Lysander, Sheerin Sarah
Kumar, G. Dilip
Balasubramanian, Anusha
Krishnan, Rajarajeswaran
Raghuraman, M. S.
Narayanan, S. Vijay
author_facet Lysander, Sheerin Sarah
Kumar, G. Dilip
Balasubramanian, Anusha
Krishnan, Rajarajeswaran
Raghuraman, M. S.
Narayanan, S. Vijay
author_sort Lysander, Sheerin Sarah
collection PubMed
description BACKGROUND: Laparoscopic surgery in recent times has noteworthy advantages over conventional surgery, yet recovery is prolonged due to debilitating shoulder tip pain (STP) and operated site pain. Various studies have compared the effect of trocar site, intraperitoneal instillation of local anesthetic (LA) for pain relief while only a few studies have tested the combination of these two techniques. Hence, this study was undertaken to compare the combination of these two techniques versus trocar site alone for STP particularly. SUBJECTS AND METHODS: This prospective, randomized, comparative study was conducted on 52 patients who were undergoing laparoscopic abdominal surgery. The patients were allocated into either of the two groups. Group I (n = 26): trocar site infiltration (20 mL) and intraperitoneal instillation (20 mL) of 0.25% levobupivacaine and Group II (n = 26): trocar site infiltration (20 mL) of 0.25% levobupivacaine and saline (20 mL) intraperitoneally. Postoperative STP was the primary outcome while surgical site pain, nausea, and vomiting were secondary outcomes. RESULTS: There were no statistically significant differences between the groups with regard to shoulder pain, surgical site pain, total rescue analgesics, and incidence of nausea and vomiting (P > 0.05). CONCLUSION: Trocar site infiltration with intraperitoneal instillation of LA or trocar site infiltration alone was found to be equally effective. However, we suggest that it is better to provide a combination of trocar site infiltration plus intraperitoneal instillation of LA if we have to restrict opioid usage such as in day-care surgeries.
format Online
Article
Text
id pubmed-9004265
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Wolters Kluwer - Medknow
record_format MEDLINE/PubMed
spelling pubmed-90042652022-04-13 Comparison of Trocar Site versus Trocar Site Plus Intraperitoneal Instillation of Local Anesthetic for Shoulder Pain Following Laparoscopic Abdominal Surgery Lysander, Sheerin Sarah Kumar, G. Dilip Balasubramanian, Anusha Krishnan, Rajarajeswaran Raghuraman, M. S. Narayanan, S. Vijay Anesth Essays Res Original Article BACKGROUND: Laparoscopic surgery in recent times has noteworthy advantages over conventional surgery, yet recovery is prolonged due to debilitating shoulder tip pain (STP) and operated site pain. Various studies have compared the effect of trocar site, intraperitoneal instillation of local anesthetic (LA) for pain relief while only a few studies have tested the combination of these two techniques. Hence, this study was undertaken to compare the combination of these two techniques versus trocar site alone for STP particularly. SUBJECTS AND METHODS: This prospective, randomized, comparative study was conducted on 52 patients who were undergoing laparoscopic abdominal surgery. The patients were allocated into either of the two groups. Group I (n = 26): trocar site infiltration (20 mL) and intraperitoneal instillation (20 mL) of 0.25% levobupivacaine and Group II (n = 26): trocar site infiltration (20 mL) of 0.25% levobupivacaine and saline (20 mL) intraperitoneally. Postoperative STP was the primary outcome while surgical site pain, nausea, and vomiting were secondary outcomes. RESULTS: There were no statistically significant differences between the groups with regard to shoulder pain, surgical site pain, total rescue analgesics, and incidence of nausea and vomiting (P > 0.05). CONCLUSION: Trocar site infiltration with intraperitoneal instillation of LA or trocar site infiltration alone was found to be equally effective. However, we suggest that it is better to provide a combination of trocar site infiltration plus intraperitoneal instillation of LA if we have to restrict opioid usage such as in day-care surgeries. Wolters Kluwer - Medknow 2021 2022-03-08 /pmc/articles/PMC9004265/ /pubmed/35422541 http://dx.doi.org/10.4103/aer.aer_156_21 Text en Copyright: © 2022 Anesthesia: Essays and Researches https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Lysander, Sheerin Sarah
Kumar, G. Dilip
Balasubramanian, Anusha
Krishnan, Rajarajeswaran
Raghuraman, M. S.
Narayanan, S. Vijay
Comparison of Trocar Site versus Trocar Site Plus Intraperitoneal Instillation of Local Anesthetic for Shoulder Pain Following Laparoscopic Abdominal Surgery
title Comparison of Trocar Site versus Trocar Site Plus Intraperitoneal Instillation of Local Anesthetic for Shoulder Pain Following Laparoscopic Abdominal Surgery
title_full Comparison of Trocar Site versus Trocar Site Plus Intraperitoneal Instillation of Local Anesthetic for Shoulder Pain Following Laparoscopic Abdominal Surgery
title_fullStr Comparison of Trocar Site versus Trocar Site Plus Intraperitoneal Instillation of Local Anesthetic for Shoulder Pain Following Laparoscopic Abdominal Surgery
title_full_unstemmed Comparison of Trocar Site versus Trocar Site Plus Intraperitoneal Instillation of Local Anesthetic for Shoulder Pain Following Laparoscopic Abdominal Surgery
title_short Comparison of Trocar Site versus Trocar Site Plus Intraperitoneal Instillation of Local Anesthetic for Shoulder Pain Following Laparoscopic Abdominal Surgery
title_sort comparison of trocar site versus trocar site plus intraperitoneal instillation of local anesthetic for shoulder pain following laparoscopic abdominal surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004265/
https://www.ncbi.nlm.nih.gov/pubmed/35422541
http://dx.doi.org/10.4103/aer.aer_156_21
work_keys_str_mv AT lysandersheerinsarah comparisonoftrocarsiteversustrocarsiteplusintraperitonealinstillationoflocalanestheticforshoulderpainfollowinglaparoscopicabdominalsurgery
AT kumargdilip comparisonoftrocarsiteversustrocarsiteplusintraperitonealinstillationoflocalanestheticforshoulderpainfollowinglaparoscopicabdominalsurgery
AT balasubramaniananusha comparisonoftrocarsiteversustrocarsiteplusintraperitonealinstillationoflocalanestheticforshoulderpainfollowinglaparoscopicabdominalsurgery
AT krishnanrajarajeswaran comparisonoftrocarsiteversustrocarsiteplusintraperitonealinstillationoflocalanestheticforshoulderpainfollowinglaparoscopicabdominalsurgery
AT raghuramanms comparisonoftrocarsiteversustrocarsiteplusintraperitonealinstillationoflocalanestheticforshoulderpainfollowinglaparoscopicabdominalsurgery
AT narayanansvijay comparisonoftrocarsiteversustrocarsiteplusintraperitonealinstillationoflocalanestheticforshoulderpainfollowinglaparoscopicabdominalsurgery