Superior somatic pain relief and improved visceral pain control is achieved using pre-emptive analgesia for laparoscopic cholecystectomy: A randomized controlled trial
Document Type
Article
Publication Date
1-1-2012
Abstract
BACKGROUND: Laparoscopic cholecystectomy, although is less invasive than open surgery, is not completely pain free. The use of local anaesthesia to relieve pain following this procedure is a common practice. However, it remains debatable whether a pre- or post-operative drug administration is more effective. Here, we investigated the role of preemptive local anaesthetic infiltration given pre- or post-incisional, in relieving the pain during laparoscopic surgery. METHODOLOGY: A randomized controlled trial was conducted with 96 patients receiving 0.5% Bupivacaine 100mg. Group A (n=48) received post-incisional skin infiltration whilst Group B (n=48) received pre-incisional infiltration. Incisional (somatic) and intra-abdominal (visceral) pain was assessed using Visual Analog Scale (VAS) at day 0, day 1 and day 7 post-operative days. RESULT: Baseline characteristics between the two groups were similar. Incisional pain was lower in Group B as compared to Group A at day 0 (P=0.03) and day 1 (P<0.01). Intra-abdominal pain was also lower in Group B at day 0 and day 1 (P=0.04). VAS score was similar at day 7 although analgesia requirement is higher in Group A (P>0.05). CONCLUSION: Administration of pre-incisional local anaesthesia offers better pre-emptive pain relief measure than post-incisional administration by reducing somatic and visceral pain in laparoscopic gall bladder surgery.
Keywords
Laparoscopic cholecystectomy, Preemptive analgesia, Pain, Ethnicity, Local anaesthesia
Publication Title
Journal of Health and Translational Medicine
Divisions
fac_med
Volume
15
Issue
2
Publisher
University of Malaya Medical Centre