Infiltración intraincisional vs. intraperitoneal de anestésico local para el control temprano del dolor post colecistectomía laparoscópica

Infiltración intraincisional vs. intraperitoneal de anestésico local para el control temprano del dolor post colecistectomía laparoscópica  Intraincisional vs intraperitoneal infiltration of local anaesthetic for controlling early post-laparoscopic cholecystectomy pain. El-labban GM, Hokkam EN, El-labban MA, Morsy K, Saadl S, Heissam KS.J Min Access Surg 2011;7:173-7 Background: The study was designed to compare the effect of intraincisional vs intraperitoneal infiltration of levobupivacaine 0.25% on post-operative pain in laparoscopic cholecystectomy. Materials and Methods: This randomised controlled study was carried out on 189 patients who underwent laparoscopic cholecystectomy. Group 1 was the control group and did not receive either intraperitoneal or intraincisional levobupivacaine. Group 2 was assigned to receive local infiltration (intraincisional) of 20 ml solution of levobupivacaine 0.25%, while Group 3 received 20 ml solution of levobupivacaine 0.25% intraperitoneally. Post-operative pain was recorded for 24 hours post-operatively. Results: Post-operative abdominal pain was significantly lower with intraincisional infiltration of levobupivacaine 0.25% in group 2. This difference was reported from 30 minutes till 24 hours post-operatively. Right shoulder pain showed significantly lower incidence in group 2 and group 3 compared to control group. Although statistically insignificant, shoulder pain was less in group 3 than group 2. Conclusion: Intraincisional infiltration of levobupivacaine is more effective than intraperitoneal route in controlling post-operative abdominal pain. It decreases the need for rescue analgesia. http://www.journalofmas.com/article.asp?issn=0972-9941;year=2011;volume=7;issue=3;spage=173;epage=177;aulast=El-labban

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