A randomized placebo controlled trial comparison of pre-incision infiltration of a local anaesthetic drug to reduce postoperative pain after laparoscopic adrenalectomy

Authors

  • Vatachanont Jiramanee MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Tanet Thaidumrong MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Vorapot Choonhaklai MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Somkiet Pumpaisanchai MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Nattapong Wongwattanasatien MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Sermsin Sindhubodee MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Chawawat Kosrisirikul MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Matchima Huabkong MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Penkhae Jereerat MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Somjith Duangkae MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Pornvadee Pisansalhidikam MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Kraisri Tuipae MIS Urology-Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand

Keywords:

Pre-incision infiltration, local anaesthetic, post-operative pain, laparoscopic adrenalectomy

Abstract

Objective:  To study the efficacy of pre-incision infiltration of a local anaesthetic drug in postoperative pain following laparoscopic adrenalectomy.

Material and Method:  In a randomized placebo controlled study, 52 patients listed for unilateral laparoscopic adrenalectomy were randomized into 2 groups. Group I (n=26) received subcuticular pre-incision infiltration with 0.5% bupivacaine and group II (n=26) received normal saline as a placebo; all the operations were performed with the same technique by only one experienced laparoscopic urologist. Postoperative pain was assessed using the Visual Analogue Scale at the 4th, 8th, 12th, 24th, and 48th hour postoperatively as primary outcomes. The secondary outcomes were the total postoperative analgesic consumption and time to the first analgesic demand.

Results:  The average pain scores were significantly different at the 4th, 12th, 24th, and 48th hour postoperatively (p=0.00, 0.00, 0.001, 0.00), but insignificantly different at the 8th hour (p=0.311). There was no significant difference in nausea/vomiting, bruising score and wound infection (p=0.223, 0.298, 0.313). Postoperative analgesic consumption was significantly lower in the bupivacaine group, but time to the first analgesic demand was not significantly longer in this study.

Conclusion:  Our study demonstrated that pre-incision infiltration of a local anaesthetic drug is highly effective for relief of postoperative pain after laparoscopic
adrenalectomy in terms of pain perception and intravenous postoperative analgesic consumption without any effects on nausea/vomiting, bruising, and wound infection.

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Published

2020-12-02

How to Cite

Jiramanee, V., Thaidumrong, T., Choonhaklai, V., Pumpaisanchai, S., Wongwattanasatien, N., Sindhubodee, S., Kosrisirikul, C., Huabkong, M., Jereerat, P., Duangkae, S., Pisansalhidikam, P., & Tuipae, K. (2020). A randomized placebo controlled trial comparison of pre-incision infiltration of a local anaesthetic drug to reduce postoperative pain after laparoscopic adrenalectomy. Insight Urology, 41(2), 36–41. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/247837

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