Korean J Pain.  2008 Apr;21(1):44-50. 10.3344/kjp.2008.21.1.44.

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

• Lee C
• Song YK

• KMID: 1480645
• DOI: http://doi.org/10.3344/kjp.2008.21.1.44

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.

Keyword

laparoscopic cholecystectomy; levobupivacaine; postoperative pain; remifentanil

MeSH Terms

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
Analgesics
Analgesics, Opioid
Anesthetics, Local
Bupivacaine
Hypogonadism
Methyl Ethers
Mitochondrial Diseases
Ophthalmoplegia
Piperidines