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. 2023 Aug 11:16:2791-2801.
doi: 10.2147/JPR.S422454. eCollection 2023.

Effect of a Local Anesthetic Injection Kit on Pain Relief and Postoperative Recovery After Transumbilical Single-Incision Laparoscopic Cholecystectomy

Na Yang #  1 , Qing-Yu Tao #  1 , Jing-Yi Niu  1 , Hao Sun  1 , Yan He  1   2 , Yong-Bo Hou  1   2 , Hong Luo  1 , Zhi Zhang  3 , Jun-Ma Yu  1
Affiliations

Effect of a Local Anesthetic Injection Kit on Pain Relief and Postoperative Recovery After Transumbilical Single-Incision Laparoscopic Cholecystectomy

Na Yang et al. J Pain Res. .

Abstract

Purpose: This study was conducted to explore whether incisional infiltration using a local anesthetic injection kit could better relieve postoperative pain and enhance the quality of recovery compared with ultrasound-guided rectus sheath block (RSB) or conventional local anesthetic infiltration in patients undergoing transumbilical single-incision laparoscopic cholecystectomy (SILC).

Patients and methods: A total of 60 patients undergoing SILC with American Society of Anesthesiology functional status scores of I-II were randomized into the rectus sheath block group (RSB group), conventional local wound infiltration group (LAI-I group) and incisional infiltration using a local anesthetic injection kit group (LAI-II group). The primary outcomes were the patient-controlled intravenous analgesia (PCIA) demand frequency within 48 hours after the operation and postoperative pain measured by a visual analog scale (VAS) at 2 h, 4 h, 8 h, 24 h, and 48 h after surgery. Secondary outcomes were the total procedure times, cumulative consumption of anesthetic drugs, duration of surgery, duration and awaking time of anesthesia, early recovery indicator and side effects.

Results: The PCIA demand frequency in LAI-II group was significantly lower compared with patients in the RSB and LAI-I group (both P < 0.001). Moreover, the total procedure times in LAI-I and LAI-II group was significantly shorter than that in the RSB group (P < 0.001, respectively), but it was comparable between LAI-I and LAI-II group (P = 0.471). Though lower at 2h and 4h postoperative in LAI-II group, pain scores at each time point had no statistical differences among three groups. There were no significant differences among three groups for other outcomes as well.

Conclusion: The effect of ultrasound-guided RSB and conventional local anesthetic infiltration in SILC patients were found to be similar in terms of relieving postoperative pain and promoting recovery. Incisional infiltration using a local anesthetic injection kit can significantly reduce the demand frequency of PCIA, which serves as a rescue analgesic.

Keywords: laparoscopic cholecystectomy; local infiltration analgesia; pain; recovery; rectus sheath block.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
An injection kit composed of a disposable epidural syringe reflecting pressure (5 mL, (A-a and B-a)), a disposable triplet (5 mL, (A-b and B-b)), a disposable puncture needle for anesthesia (AN-SI, 0.7×106, (A-c and B-c)) and another disposable puncture needle for anesthesia (AN-E, 1.2×80, (A-d and B-d)) all from TUORen Medical Equipment Co., Henan, China (A and B). When the air bubble of the syringe (A-b and B-b) was shrunk during the kit was advancing, the puncture needle for anesthesia (AN-SI, 0.7×106, (A-c and B-c)) was withdrew. Then the ropivacaine mixed with dexmedetomidine was injected through the disposable puncture needle (A-d and B-d). The operation process and the flow diagram are as (C-A and D-A and C-b and D-b) of Figure 1, respectively.
Figure 2
Figure 2
CONSORT diagram of study.
Figure 3
Figure 3
Average VAS scores in three groups for various time points of follow-up.
See this image and copyright information in PMC

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