A new method of preemptive analgesia in laparoscopic cholecystectomy.
BACKGROUND
Although laparoscopic cholecystectomy (LC) results in less pain then open cholecystectomy, it is not a pain-free procedure. The aim of this study was to test a new method of preemptive analgesia.


METHODS
By simple randomization 60 patients were assigned to two groups (30 in each group). Group A, the placebo group, received 200 ml of 0.9% saline, and group B received 5 mg/kg of a local anesthetic solution (ropivacaine) in 200 ml of 0.9% saline. Local anesthetic or placebo solution were administer before creation of the pneumoperitoneum.


RESULTS
Pain intensity, as rated by visual analog and verbal rating scales, and stress response data were significantly less in the group receiving ropivacaine than in the placebo group. No patients in treatment group received an additional dose of analgesic, whereas two patients in placebo group needed an additional analgesic.


CONCLUSIONS
Our results support the clinical validity of preemptive analgesia, but the timing of intraperitoneal administration of local anesthetic is very important. Only application before creation of the pneumoperitoneum may preempt every neuronal central sensitization.
Maestroni
U
U
Department of Surgery, Anaesthsiology, and Radiology, University of Ferrara, C.so Giovecca 203, Ferrara, Italy.
Sortini
D
D
Devito
C
C
Pour Morad Kohan Brunaldi
F
F
Anania
G
G
Pavanelli
L
L
Pasqualucci
A
A
Donini
A
A
D000577:Amides / Q000097:blood / Q000627:therapeutic use; D000698:Analgesia / Q000379:methods* / Q000639:trends; D000779:Anesthetics, Local / Q000097:blood / Q000627:therapeutic use; D017081:Cholecystectomy, Laparoscopic / Q000379:methods* / Q000639:trends; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000097:blood / Q000473:pathology / Q000517:prevention & control*; D011028:Pneumoperitoneum, Artificial / Q000379:methods / Q000639:trends; D000077212:Ropivacaine; D013312:Stress, Physiological / Q000097:blood / Q000473:pathology / Q000517:prevention & control
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine