This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Boddy, A. P. Articles by Rhodes, M. Search for Related Content PubMed PubMed Citation Articles by Boddy, A. P. Articles by Rhodes, M. Related Collections Regional Anesthesia Pain Pharmacology

---

GENERAL ARTICLES

The Effect of Intraperitoneal Local Anesthesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis

From the Department of General Surgery, Norfolk and Norwich University Hospital, United Kingdom.

Address correspondence and reprint requests to M. Rhodes, MD, Consultant Surgeon, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk, NR4 7UY, United Kingdom. Address e-mail to mr{at}lapsurgeon.co.uk.

Intraperitoneal administration of local anesthesia is often used to improve pain relief after laparoscopic cholecystectomy. We have conducted a meta-analysis to establish the efficacy of this technique in reducing early postoperative abdominal pain. A systematic literature search revealed 24 randomized, controlled trials assessing intraperitoneal local anesthetic use in laparoscopic cholecystectomy that met inclusion criteria. Of these, 16 studies reported sufficient data to allow pooled quantitative analysis. The weighted mean differences (WMD) in visual analog pain score at 4 h after surgery were pooled using a random effects model. Overall, the use of intraperitoneal local anesthesia resulted in a significantly reduced pain score at 4 h (WMD, –9 mm; 95% confidence interval [CI], –13 to –5). Subgroup analysis suggested that the effect was greater when the local anesthetic was given at the start of the operation (WMD, –13 mm; 95% CI, –19 to –7) compared with instillation at the end (WMD, –6 mm; 95% CI, –10 to –2). No adverse events related to local anesthetic toxicity were reported. We conclude that the use of intraperitoneal local anesthesia is safe, and it results in a statistically significant reduction in early postoperative abdominal pain.

This article has been cited by other articles:

				A. A. El-Dawlatly, A. Turkistani, S. C. Kettner, A.-M. Machata, M. B. Delvi, A. Thallaj, S. Kapral, and P. Marhofer Ultrasound-guided transversus abdominis plane block: description of a new technique and comparison with conventional systemic analgesia during laparoscopic cholecystectomy Br. J. Anaesth., June 1, 2009; 102(6): 763 - 767. [Abstract] [Full Text] [PDF]

				G. Tzovaras, F. Fafoulakis, K. Pratsas, S. Georgopoulou, G. Stamatiou, and C. Hatzitheofilou Spinal vs General Anesthesia for Laparoscopic Cholecystectomy: Interim Analysis of a Controlled Randomized Trial Arch Surg, May 1, 2008; 143(5): 497 - 501. [Abstract] [Full Text] [PDF]

				M. J. Paech, K. F. Ilett, L. P. Hackett, M. Page-Sharp, and R. W. Parsons Disposition and Clinical Outcome After Intraperitoneal Meperidine and Ropivacaine Administration During Laparoscopic Surgery Anesth. Analg., January 1, 2008; 106(1): 278 - 286. [Abstract] [Full Text] [PDF]

				S. Purkayastha, N. A. Alkhamesi, and A. W. Darzi Intraperitoneal Local Anesthesia During Laparoscopic Cholecystectomy: The Role of Meta-Analytical Subgroups and Delivery of the Local Anesthetic Anesth. Analg., April 1, 2007; 104(4): 994 - 994. [Full Text] [PDF]