Effect of intraperitoneal local anesthetic on pain characteristics after laparoscopic cholecystectomy

作     者：Geun Joo Choi Hyun Kang Chong Wha Baek Yong Hun Jung Dong Rim Kim 

作者机构：Department of Anesthesiology and Pain Medicine Chung-Ang University College of Medicine 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第47期

页      面：13386-13395页

核心收录：

学科分类：1002[医学-临床医学] 100217[医学-麻醉学] 10[医学] 

主　　题：Local anesthetic Laparoscopic cholecystectomy Intraperitoneal Meta-analysis Pain 

摘      要：AIM : To systematically evaluate the effect of intraperitoneal local anesthetic on pain characteristics after laparoscopic cholecystectomy(LC).METHODS: We searched MEDLINE, EMBASE, and the Cochrane Library. Randomized controlled trials in English that compared the effect of intraperitoneal administration of local anesthetics on pain with that of placebo or nothing after elective LC under general anesthesia were included. The primary outcome variables analyzed were the combined scores of abdominal, visceral, parietal, and shoulder pain after LC at multiple time points. We also extracted pain scores at resting and dynamic ***: We included 39 studies of 3045 patients in total. The administration of intraperitoneal local anesthetic reduced pain intensity in a resting state after laparoscopic cholecystectomy: abdominal [standardized mean difference(SMD) =-0.741; 95%CI:-1.001 to-0.48, P 0.001]; visceral(SMD =-0.249; 95%CI:-0.493 to-0.006, P = 0.774); and shoulder(SMD =-0.273; 95%CI:-0.464 to-0.082, P = 0.097). Application of intraperitoneal local anesthetic significantly reduced the incidence of shoulder pain(RR = 0.437; 95%CI: 0.299 to 0.639, P 0.001). There was no favorable effect on resting parietal or dynamic abdominal ***: Intraperitoneal local anesthetic as an analgesic adjuvant in patients undergoing laparoscopic cholecystectomy exhibited beneficial effects on postoperative abdominal, visceral, and shoulder pain in a resting state.