Intraperitoneal Lavage with Bupivacaine 0.2% and Post-operative Pain in Laparoscopic Colorectal Surgery: A Prospective, Double-Blind, Randomized Controlled Trial

Background: Local anesthetics have been proven as a method to reduce postoperative pain and opioid use. It reduces side effects associated with drug use and may improve patient health and reduce hospital length of stay. The aim of this study was to evaluate the effect of intraperitoneal bupivacaine...

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Main Authors: Mahdi Alemrajabi, Mohammadreza Ghodraty, Farnaz Safakhah, Mohammad Moradi, Alireza Pournajafian
Format: Article
Language:English
Published: Kerman University of Medical Sciences 2020-11-01
Series:Journal of Kerman University of Medical Sciences
Subjects:
Online Access:https://jkmu.kmu.ac.ir/article_91526_4732c848eedc182500e6115ce1bc12f1.pdf
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author Mahdi Alemrajabi
Mohammadreza Ghodraty
Farnaz Safakhah
Mohammad Moradi
Alireza Pournajafian
author_facet Mahdi Alemrajabi
Mohammadreza Ghodraty
Farnaz Safakhah
Mohammad Moradi
Alireza Pournajafian
author_sort Mahdi Alemrajabi
collection DOAJ
description Background: Local anesthetics have been proven as a method to reduce postoperative pain and opioid use. It reduces side effects associated with drug use and may improve patient health and reduce hospital length of stay. The aim of this study was to evaluate the effect of intraperitoneal bupivacaine on post-operative pain in laparoscopic colorectal surgery. Methods: In this prospective randomized control trial, 63 patients aged 20-70 years candidates for laparoscopic proctectomy or rectopexy surgery, were divided into two groups. In the case group, anastomosis site was washed with 50 mL of bupivacaine 0.2% intraperitoneally. In the control group, equal volume of normal saline was used as placebo. Intravenous autofuser pain control filled with 3 g paracetamol was considered for all patients. Visual analogue scale (VAS) was recorded at 2, 8, 24 hours and narcotic usage was recorded totally for the first 24 hours after the operation. Results: There was no significant difference between pain scores according to the VAS criteria at 2, 8, and 24 hours after the operation in the case and control groups (P>0.05). Total pethidine consumption during the first 24 hours after the operation was lower in the bupivacaine group (49.03 ± 45.77) compared to the control group (77.74 ± 63.50), but the difference was not significant (P>0.05). However, the total dose of pethidine used after 24 hours after proctectomy (not rectopexy) was significantly lower in the bupivacaine group than that in the control group (p <0.05). Conclusion: Intraperitoneal lavage with bupivacaine during the operation reduced post-operative total narcotics use in patients who underwent laparoscopic proctectomy, not in rectopexy.
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spelling doaj.art-5bf9ae767f594b94ac1ce1937368309c2023-07-01T05:15:44ZengKerman University of Medical SciencesJournal of Kerman University of Medical Sciences2008-28432020-11-0127651051910.22062/jkmu.2020.9152691526Intraperitoneal Lavage with Bupivacaine 0.2% and Post-operative Pain in Laparoscopic Colorectal Surgery: A Prospective, Double-Blind, Randomized Controlled TrialMahdi Alemrajabi0Mohammadreza Ghodraty1Farnaz Safakhah2Mohammad Moradi3Alireza Pournajafian4Assistant Professor of Surgery, Fellowship of colorectal surgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IranAssociate Professor of Anesthesia, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IranResident of Anesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IranResident of General Surgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IranAssociate Professor of Anesthesia, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IranBackground: Local anesthetics have been proven as a method to reduce postoperative pain and opioid use. It reduces side effects associated with drug use and may improve patient health and reduce hospital length of stay. The aim of this study was to evaluate the effect of intraperitoneal bupivacaine on post-operative pain in laparoscopic colorectal surgery. Methods: In this prospective randomized control trial, 63 patients aged 20-70 years candidates for laparoscopic proctectomy or rectopexy surgery, were divided into two groups. In the case group, anastomosis site was washed with 50 mL of bupivacaine 0.2% intraperitoneally. In the control group, equal volume of normal saline was used as placebo. Intravenous autofuser pain control filled with 3 g paracetamol was considered for all patients. Visual analogue scale (VAS) was recorded at 2, 8, 24 hours and narcotic usage was recorded totally for the first 24 hours after the operation. Results: There was no significant difference between pain scores according to the VAS criteria at 2, 8, and 24 hours after the operation in the case and control groups (P>0.05). Total pethidine consumption during the first 24 hours after the operation was lower in the bupivacaine group (49.03 ± 45.77) compared to the control group (77.74 ± 63.50), but the difference was not significant (P>0.05). However, the total dose of pethidine used after 24 hours after proctectomy (not rectopexy) was significantly lower in the bupivacaine group than that in the control group (p <0.05). Conclusion: Intraperitoneal lavage with bupivacaine during the operation reduced post-operative total narcotics use in patients who underwent laparoscopic proctectomy, not in rectopexy.https://jkmu.kmu.ac.ir/article_91526_4732c848eedc182500e6115ce1bc12f1.pdfpainbupivacaineproctectomyrectopexy
spellingShingle Mahdi Alemrajabi
Mohammadreza Ghodraty
Farnaz Safakhah
Mohammad Moradi
Alireza Pournajafian
Intraperitoneal Lavage with Bupivacaine 0.2% and Post-operative Pain in Laparoscopic Colorectal Surgery: A Prospective, Double-Blind, Randomized Controlled Trial
Journal of Kerman University of Medical Sciences
pain
bupivacaine
proctectomy
rectopexy
title Intraperitoneal Lavage with Bupivacaine 0.2% and Post-operative Pain in Laparoscopic Colorectal Surgery: A Prospective, Double-Blind, Randomized Controlled Trial
title_full Intraperitoneal Lavage with Bupivacaine 0.2% and Post-operative Pain in Laparoscopic Colorectal Surgery: A Prospective, Double-Blind, Randomized Controlled Trial
title_fullStr Intraperitoneal Lavage with Bupivacaine 0.2% and Post-operative Pain in Laparoscopic Colorectal Surgery: A Prospective, Double-Blind, Randomized Controlled Trial
title_full_unstemmed Intraperitoneal Lavage with Bupivacaine 0.2% and Post-operative Pain in Laparoscopic Colorectal Surgery: A Prospective, Double-Blind, Randomized Controlled Trial
title_short Intraperitoneal Lavage with Bupivacaine 0.2% and Post-operative Pain in Laparoscopic Colorectal Surgery: A Prospective, Double-Blind, Randomized Controlled Trial
title_sort intraperitoneal lavage with bupivacaine 0 2 and post operative pain in laparoscopic colorectal surgery a prospective double blind randomized controlled trial
topic pain
bupivacaine
proctectomy
rectopexy
url https://jkmu.kmu.ac.ir/article_91526_4732c848eedc182500e6115ce1bc12f1.pdf
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