title: Efficacy of Repeated Intraperitoneal Administration of Levobupivacaine in Pain and Opioid Consumption After Elective Laparoscopic Cholecystectomy: A Prospective Randomized Placebo-controlled Trial.
abstract: OBJECTIVE
  To estimate the effect of intraperitoneal levobupivacaine on postoperative pain and analgesic requirements, during the first 24 hours after elective laparoscopic cholecystectomy (LC).
  
  
  METHODS
  In this prospective, randomized, placebo-controlled study, 73 consecutive patients scheduled for LC were randomized into 2 groups. In the local anesthetic group 36 patients received 10 mL of 0.5% levobupivacaine intraperitoneally at the end of the LC and at 4 hours postoperatively, whereas in the placebo group 37 patients received 10 mL of 0.9% normal saline. Visual analog scale pain scores, analgesic consumption, side-effects, and vital signs were recorded for 24 hours postoperatively.
  
  
  RESULTS
  In the local anesthetic group lower visual analog scale pain scores were observed postoperatively, both at rest and at movement (P-values compared with placebo, 0.012 and <0.001, respectively). Fentanyl consumption was greater in the placebo group (P-value <0.001).
  
  
  CONCLUSIONS
  Intraperitoneal administration of 10 mL 0.5% levobupivacaine after LC is effective in reducing postoperative pain and decreasing opioid consumption.
authors.affiliation: *Department of Anesthesiology, "Hippocration" General Hospital †2nd University Department of Anesthesiology, "Attikon" General Hospital ‡1st University Department of Propaedeutic Surgery, "Hippocration" General Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Melidi
authors.forename: Artemisia
authors.initials: A
authors.lastname: Papadima
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Pandazi
authors.forename: George
authors.initials: G
authors.lastname: Zografos
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007274:Injections, Intraperitoneal; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D020069:Shoulder Pain / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077554:Levobupivacaine; D005283:Fentanyl; D002045:Bupivacaine