Intraperitoneal local anaesthetic for shoulder pain after day-case laparoscopy.
Laparoscopy is frequently associated with postoperative shoulder pain that may last several days. We have assessed the analgesic effect of intraperitoneal local anaesthetics during day-case diagnostic laparoscopy. 80 young women were randomly assigned to one of four groups of 20 patients each: group 1, no peritoneal administration; group 2, 80 ml saline injected under direct vision in the right subdiaphragmatic area at the start of the procedure; group 3, 80 ml 0.5% lignocaine with adrenaline (320,000 dilution); group 4, 0.125% bupivacaine with adrenaline (800,000 dilution). Scapular pain was assessed with a visual analogue pain scale, and information about nausea, vomiting, abdominal pain, and analgesic requirements during the first 48 h was sought. Both local anaesthetics were more effective in reducing postoperative shoulder pain than either control or saline. Analgesic requirements were greater in the non-treatment groups than in the local anaesthetic groups. Intraperitoneal local anaesthetic administration during laparoscopy is both a non-invasive and an efficient method of reducing the intensity of scapular pain.
Department of Anaesthesia, Hôpital Antoine Béclère, Clamart, France.
P
P
Narchi
D
D
Benhamou
H
H
Fernandez
D000328:Adult; D000779:Anesthetics, Local; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D010537:Peritoneum; D012782:Shoulder
D000779:Anesthetics, Local