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Evaluation of a local anaesthesia regimen using a subphrenic catheter after gynaecological laparoscopy

Published online by Cambridge University Press:  02 June 2005

Y. Ozer ,
H. A. Tanriverdi ,
I. Ozkocak ,
H. Altunkaya ,
C. B. Demirel ,
U. Bayar  and
A. Barut
Y. Ozer
Affiliation:
Zonguldak Karaelmas University Hospital, Department of Anaesthesiology and Reanimation, Zonguldak, Turkey
H. A. Tanriverdi
Affiliation:
Zonguldak Karaelmas University Hospital, Department of Obstetrics and Gynaecology, Zonguldak, Turkey
I. Ozkocak
Affiliation:
Zonguldak Karaelmas University Hospital, Department of Anaesthesiology and Reanimation, Zonguldak, Turkey
H. Altunkaya
Affiliation:
Zonguldak Karaelmas University Hospital, Department of Anaesthesiology and Reanimation, Zonguldak, Turkey
C. B. Demirel
Affiliation:
Zonguldak Karaelmas University Hospital, Department of Anaesthesiology and Reanimation, Zonguldak, Turkey
U. Bayar
Affiliation:
Zonguldak Karaelmas University Hospital, Department of Obstetrics and Gynaecology, Zonguldak, Turkey
A. Barut
Affiliation:
Zonguldak Karaelmas University Hospital, Department of Obstetrics and Gynaecology, Zonguldak, Turkey
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Extract

Summary

Background and objective: The purpose of intraperitoneal local anaesthetic administration is to block visceral nociceptive conduction and to provide an additional route of analgesia. The present study evaluates the effects of sequential injections of bupivacaine on postoperative pain through a subphrenic catheter.

Methods: In this double-blinded controlled study, patients scheduled for gynaecological laparoscopy were randomly divided into two groups. One group received 20 mL of saline with 1 : 200 000 epinephrine through a subphrenic catheter before the incision closure and at 4-hourly intervals for the first postoperative 20 h. The second group received 20 mL of bupivacaine 0.125% with 1 : 200 000 epinephrine at the same injection times. Postoperative pain scores and consumption of analgesics were compared.

Results: There were no statistical differences in pain scores at rest or incidence of shoulder pain between the two groups, but the patients of the bupivacaine group reported lower pain scores on coughing only in the first hour postoperatively (P = 0.007). Although the patients consumed comparable amounts of metamizole and ondansetron, the number of patients requiring supplemental meperidine and flurbiprofen in the bupivacaine group were significantly lower than in the saline group (P < 0.05).

Conclusions: This study demonstrates that intraperitoneal bupivacaine may reduce pain on coughing in the early postoperative period and the consumption of analgesics postoperatively. The subphrenic catheter technique had no impact upon pain at rest and shoulder-tip pain after gynaecological laparoscopy.

Keywords

ANAESTHETIC TECHNIQUES, intraperitonealANAESTHETICS, local, bupivacaineSURGERY, laparoscopic, gynaecologicalPAIN, acute, postoperative
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 6 , June 2005 , pp. 442 - 446
Copyright
© 2005 European Society of Anaesthesiology

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