The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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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

Remifentanil을 이용한 전신마취하에 시행된 복강경 담낭절제술에서 0.25% Levobupivacaine의 트로카 부위침윤과 복강 내 점적주입이 수술 후 진통에 미치는 효과

  • Lee, Cheol (Department of Anesthesiology and Pain Medicine, School of Medicine, Wonkwang University) ;
  • Song, Yoon Kang (Department of Anesthesiology and Pain Medicine, School of Medicine, Wonkwang University)
  • 이철 (원광대학교 의과대학 마취통증의학교실) ;
  • 송윤강 (원광대학교 의과대학 마취통증의학교실)
  • Received : 2008.01.17
  • Accepted : 2008.03.18
  • Published : 2008.06.01
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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.

Keywords

Acknowledgement

Supported by : 원광대학교

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