Preemptive analgesia in the laparoscopic patient.
BACKGROUND
One hundred consecutive laparoscopic patients were prospectively followed in the Post-anesthesia Recovery Unit (PAR) in a community hospital.


METHODS
Data was collected regarding (1) intraoperative administration of ketorolac, (2) instillation of local anesthesia into the wound, and (3) requirements for analgesic administration in the PAR. Those patients receiving both forms of preemptive analgesia required less narcotic administration in the PAR. The results were highly significant.


RESULTS
Based on these data and the observance of markedly reduced pain in patients during the early postoperative period, an institutional plan of care was developed which has resulted in the virtual elimination of the need to administer narcotics to patients undergoing routine laparoscopic surgical procedures.


CONCLUSIONS
The resultant plan of care, which includes preemptive analgesia, rapid ambulation, early feeding, and routine timed administration of non-narcotic pain medications, is presented. Data is also presented which demonstrates a more rapid discharge of patients from the hospital.
Mixter
C G
CG
Exeter Hospital, Exeter, NH 03833, USA.
Hackett
T R
TR
D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000779:Anesthetics, Local; D002045:Bupivacaine; D016022:Case-Control Studies; D004434:Early Ambulation; D006801:Humans; D007430:Intraoperative Care; D020910:Ketorolac; D010535:Laparoscopy; D010149:Postoperative Pain / Q000517:prevention & control*; D014046:Tolmetin / Q000031:analogs & derivatives* / Q000627:therapeutic use
D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D014046:Tolmetin; D002045:Bupivacaine; D020910:Ketorolac