Abstract | BACKGROUND: METHODS: The authors searched Medline, EMBase, and the Cochrane Central Register of Controlled Trials, as well as reference lists of textbooks and relevant articles. They contacted experts in the field of anesthesia and laparoscopic surgery for randomized controlled trials comparing preemptive administration of local anesthesia at the incision site or intraperitoneally with postoperative anesthesia administration or placebo. Trials were systematically assessed for eligibility and validity, and data were extracted in duplicate. The data were pooled across studies using a random effects model. RESULTS: The 26 studies that met the inclusion criteria were included in the analysis. Preemptive incisional local anesthetic was superior to placebo in terms of visual analog pain scores (VAS) at 4 h (weighted mean difference [WMD], -9.49 mm; 95% confidence interval [CI], -15.50 to -3.48) and 24 h (WMD, -4.75 mm; 95%CI, -8.90 to 0.60). However, no difference was found between these measures and those for postoperative incision-site infiltration. Preemptive intraperitoneal local anesthetic was superior to placebo in terms of VAS at 4 h (WMD, 5.76 mm; 95%CI, -11.27 to -0.25), 8 h (WMD, -9.64 mm; 95%CI, -13.68 to -5.60), 12 h (WMD, -4.68 mm; 95%CI, -5.86 to -3.49), and 24 h (WMD, -5.57 mm; 95%CI, -8.35 to -2.79), and superior to postoperative anesthesia administration at 8 h (WMD, -7.42; 95%CI, -13.40 to -1.45), 12 h (WMD, -7.27 mm; 95%CI, -10.26 to -4.28), and 24 h (WMD, -7.95 mm; 95%CI, -12.33 to -3.56). CONCLUSION:
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Authors | Shaun M Coughlin, Paul J Karanicolas, Heather M A Emmerton-Coughlin, Bilge Kanbur, Savas Kanbur, Patrick H D Colquhoun |
Journal | Surgical endoscopy
(Surg Endosc)
Vol. 24
Issue 12
Pg. 3167-76
(Dec 2010)
ISSN: 1432-2218 [Electronic] Germany |
PMID | 20490560
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Topics |
- Analgesia
(methods)
- Humans
- Laparoscopy
- Pain, Postoperative
(prevention & control)
- Time Factors
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