title: Comparıson of different postoperative paın managements in patients submitted to transperitoneal laparoscopic renal and adrenal surgery.
abstract: OBJECTIVE
  We compared the effects of local levobupivacaine infiltration, intravenous paracetamol, intravenous lornoxicam treatments on postoperative analgesia in patients submitted to transperitoneal laparoscopic renal and adrenal surgery.
  
  
  METHODS
  Sixty adult patients 26 and 70 years who underwent laparoscopic renal and adrenal surgery were randomized into three groups with 20 patients each: Group 1 received local 20 mL of levobupivacaine 0.25% infiltration to the trocar incisions before skin closure. In group 2, 1g paracetamol was given to the patients intravenously 30 minutes before extubation and 5 g paracetamol was given intravenously in the 24 postoperative period. In group 3, 8 mg lornoxicam i.v. was given 30 minutes before extubation and 8 mg lornoxicam i.v. was given in the 24 postoperative period. In the postoperative period, pain scores, cumulative tramadol, and additional pethidine consumption were evaluated.
  
  
  RESULTS
  Postoperative pain scores significantly reduced in each group (p < 0.05). Although pain levels of the groups were not significantly different at 1, 2, 4, 8, 12 and 24 hours postoperatively, cumulative tramadol consumptions were higher in group 1 than the others. (Group 1 = 370.6 ± 121.6 mg, Group 2: 220.9 ± 92.5mg, Group 3 = 240.7 ± 100.4 mg.) (p < 0.005). The average dose of pethidine administered was significantly lower in groups 2 and 3 compared with group 1 (Group 1: 145 mg, Group 2: 100mg, Group 3: 100mg) (p = 0.024).
  
  
  CONCLUSIONS
  Levobupivacaine treated group required significantly more intravenous tramadol when compared with paracetamol and lornoxicam groups in patients submitted to transperitoneal laparoscopic renal and adrenal surgery.
authors.affiliation: Third Department of Urology, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Altug
authors.initials: A
authors.lastname: Tuncel
authors.affiliation: Third Department of Urology, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Melih
authors.initials: M
authors.lastname: Balci
authors.affiliation: Second Department of Anaesthesiology, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Aysun
authors.initials: A
authors.lastname: Postaci
authors.affiliation: Third Department of Urology, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Aslan
authors.affiliation: Third Department of Urology, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Atan
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D061605:Administration, Intravenous; D000311:Adrenal Glands / Q000601:surgery*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002045:Bupivacaine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy*; D010894:Piroxicam / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D064232:Visual Analog Scale
chemical_list: D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D000082:Acetaminophen; D000077554:Levobupivacaine; C059451:lornoxicam; D002045:Bupivacaine