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KMID : 0978820080110010035
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2008 Volume.11 No. 1 p.35 ~ p.39
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The Effect of Intraperitoneal and Intra-incisional Application of Bupivacaine on Pain after Laparoscopic Cholecystectomy
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Jeon Kyung-Mo
Choi Youn-Baik
Cho Hae-Chang
Lee On-Bok
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Abstract
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Purpose: Although less painful than their open counterparts, laparoscopic procedures are far from pain-free. Post-operative pain distincts patient discomfort. The purpose of this study was to evaluate the effect of intraperitoneal and intra-incisional bupivacaine on postoperative pain and analgesic consumption after laparoscopic cholecystectomy.
Methods: Between January and March 2008, 100 patient who underwent laparoscopic cholecystectomy were randomized into one of two groups: treatment or control. At the end of the operation, before CO2 disinflation, 40 ml of 0.25%
bupivacaine was sprayed into the sub-diaphragmatic spaces bilaterally in patients from the treatment group, and the same
concentration (0.25%) of bupivacaine was injected at all trocar sites. Patients in the control group did not receive any
bupivacaine. The pain scores were evaluated by visual analogue pain scale at the second, fourth, twelfth, twentyfourth,
and forty-eighth hours. Analgesic requirements were also noted.
Results: The pain score was significantly lower in the bupivacaine group than in the control group at the second,
fourth, and twelfth hours (p＜0.05). No significant difference was noted between the two groups at the 24th hour (p=0.05). Analgesic requirements were not significantly different between the two groups (p=0.05).
Conclusion: The intraperitoneal and intra-incisional administration of bupivacaine after laparoscopic abdominal
surgery significantly reduced the pain intensity in the early postoperative period, increased patient comfort, and reduced analgesic consumption.
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KEYWORD
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Laparoscopic cholecystectomy, Local anesthesia, Intraperitoneal, Intraincisional, Pain
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