Introduction: Regional analgesic techniques with infiltration of local anesthetic represent a cornerstone in modern postoperative pain management strategies after laparoscopic surgery. If used in a right concentration, it could help in attenuation of postoperative pain with better pulmonary performance and less morbidity. Aim: to compare the effect of different concentrations of intraperitoneal bupivacaine to obtain proper pain relief after laparoscopic bariatric surgery and evaluating its effect on pulmonary functions. Patients and methods: One hundred and twenty morbidly obese patients were included in this study. Patients were divided into three group. Group (A) patients received 50 ml bupivacaine 0.25% into the coelomic cavity. Group (B) patients receive 50 ml bupivacaine 0.125% into the coelomic cavity. Group (C) control group (n=36): patients receive 50 ml of normal saline into the coelomic cavity. VAS score and pulmonary function study were examined before and at regular intervals after surgery. Total analgesic requirements and time to first analgesic rescue was recorded. Results: VAS in group (A) was significantly lower than group (C) 2 hours after surgery and lower in group (A) compared with group (B&C) at 4 and 6 hours postoperative. Postoperative morphine consumption was lower in group (A) during the first 24 hours when compared to group (B & C) respectively. Both FVC and FEV1 were higher in group (A) compared to group (B&C) at 6hours postoperative. Conclusion: intraperitoneal injection of bupivacaine 0.25% is an efficient method of decreasing the postoperative pain with better preservation of pulmonary functions in morbidly obese patients undergoing laparoscopic bariatric surgery.
| Published in | International Journal of Anesthesia and Clinical Medicine (Volume 8, Issue 2) |
| DOI | 10.11648/j.ijacm.20200802.18 |
| Page(s) | 68-73 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Analgesia, Bariatric Surgery, Pain Score, Pulmonary Functions, Recruitment Maneuvers
| [1] | Mitra S, Khandelwal P, Roberts K, Kumar S, Vadivelu N. Pain relief in laparoscopic cholecystectomy--a review of the current options. Pain Pract. 2012; 12 (6): 485–96. |
| [2] | Macfater, H., Xia, W., Srinivasa, S., Hill, A. G., Van De Velde, M., & Joshi, G. P. Evidence-based management of postoperative pain in adults undergoing laparoscopic sleeve gastrectomy. World journal of surgery, 2019. 43 (6), 1571-1580. |
| [3] | Das, N. T., & Deshpande, C. Effects of intraperitoneal local anaesthetics bupivacaine and ropivacaine versus placebo on postoperative pain after laparoscopic cholecystectomy: a randomised double blind study. Journal of clinical and diagnostic research: JCDR, 2017. 11 (7), UC08. |
| [4] | McEvoy, M. D., Scott, M. J., Gordon, D. B., Grant, S. A., Thacker, J. K., Wu, C. L.,... & Miller, T. E. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery: part 1—from the preoperative period to PACU. Perioperative Medicine, 2017. 6 (1), 1-13. |
| [5] | Han, P. Y., Duffull, S. B., Kirkpatrick, C. M. J., & Green, B. (2007). Dosing in obesity: a simple solution to a big problem. Clinical Pharmacology & Therapeutics, 2007. 82 (5), 505-508. |
| [6] | Alsulaimy, M., et al., The utility of diagnostic laparoscopy in postbariatric surgery patients with chronic abdominal pain of unknown etiology. Surgery for Obesity and Related Diseases, 2016. 12 (7): p. S71. |
| [7] | Bamgbade, O. A., O. Oluwole, and R. R. Khaw, Perioperative Analgesia for Fast-Track Laparoscopic Bariatric Surgery. Obesity Surgery, 2017. 27 (7): p. 1828–1834. |
| [8] | Wainwright T. W., Burgess L. Early Ambulation and Physiotherapy After Surgery. In: Ljungqvist O., Francis N., Urman R. (eds) Enhanced Recovery After Surgery. 2020. Springer, Cham. https://doi.org/10.1007/978-3-030-33443-7_23. |
| [9] | Alamdari, N. M., Bakhtiyari, M., Gholizadeh, B., & Shariati, C. Analgesic effect of intraperitoneal bupivacaine hydrochloride after laparoscopic sleeve gastrectomy: A randomized clinical trial. Journal of Gastrointestinal Surgery, 2018. 22 (3), 396-401. |
| [10] | Safari S, Rokhtabnak F, Motlagh SD, Garkani MG, Pournajafian A, Effect of Intraperitoneal Bupivacaine on Postoperative Pain in Laparoscopic Bariatric Surgeries, Surgery for Obesity and Related Diseases, 2019. doi: https://doi.org/10.1016/j.soard.2019.10.028. |
| [11] | Kahokehr A, Sammour T, Soop M, et al. Intraperitoneal use of local anesthetic in laparoscopic cholecystectomy: systematic review and metaanalysis of randomized controlled trials. J Hepatobiliary Pancreat Sci. 2010; 17 (5): 637–56. |
| [12] | Ebrahimifard F, Nooraei N. Postoperative pain after laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2013; 23 (1): 88–92. |
| [13] | Schipper, I. E., Schouten, M., Yalcin, T., Algie, G. D., Damen, S. L., Smeenk, R. M., & Schouten, R. (2019). The use of intraperitoneal bupivacaine in laparoscopic roux-en-y gastric bypass: a double-blind, randomized controlled trial. Obesity surgery, 2019. 29 (10), 3118-3124. |
| [14] | Cohen AR, Smith AN, Henriksen BS. Postoperative Opioid Requirements Following Roux en-Y Gastric Bypass in Patients Receiving Continuous Bupivacaine Through a Pump System: A Retrospective Review. Hosp Pharm. 2013 Jun; 48 (6): 479-83. |
| [15] | Omar, I., & Abualsel, A. Efficacy of intraperitoneal instillation of bupivacaine after bariatric surgery: randomized controlled trial. Obesity surgery, 2019. 29 (6), 1735-1741. |
| [16] | Brown, B., & Roberts, J. Principles of artificial ventilation. Anaesthesia & Intensive Care Medicine, 2019. 20 (2), 72-84. |
| [17] | Hu, Yan1; McArthur, Alexa2; Yu, Zhenghong1 Early postoperative mobilization in patients undergoing abdominal surgery: a best practice implementation project, JBI Database of Systematic Reviews and Implementation Reports: December 2019 - Volume 17 - Issue 12 - p 2591-2611. https://doi: 10.11124/JBISRIR-D-19-00063. |
APA Style
Mohammed Adel Hegazy, Hosam Hamed, Mohamed Said Salim, Mohamed Abdelraoof, Ahmed Mohamed Farid, et al. (2020). Effect of Different Concentrations of Intraperitoneal Bupivacaine on Postoperative Outcome in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery. International Journal of Anesthesia and Clinical Medicine, 8(2), 68-73. https://doi.org/10.11648/j.ijacm.20200802.18
ACS Style
Mohammed Adel Hegazy; Hosam Hamed; Mohamed Said Salim; Mohamed Abdelraoof; Ahmed Mohamed Farid, et al. Effect of Different Concentrations of Intraperitoneal Bupivacaine on Postoperative Outcome in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery. Int. J. Anesth. Clin. Med. 2020, 8(2), 68-73. doi: 10.11648/j.ijacm.20200802.18
AMA Style
Mohammed Adel Hegazy, Hosam Hamed, Mohamed Said Salim, Mohamed Abdelraoof, Ahmed Mohamed Farid, et al. Effect of Different Concentrations of Intraperitoneal Bupivacaine on Postoperative Outcome in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery. Int J Anesth Clin Med. 2020;8(2):68-73. doi: 10.11648/j.ijacm.20200802.18
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Download@article{10.11648/j.ijacm.20200802.18,
author = {Mohammed Adel Hegazy and Hosam Hamed and Mohamed Said Salim and Mohamed Abdelraoof and Ahmed Mohamed Farid and Hani Taman},
title = {Effect of Different Concentrations of Intraperitoneal Bupivacaine on Postoperative Outcome in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery},
journal = {International Journal of Anesthesia and Clinical Medicine},
volume = {8},
number = {2},
pages = {68-73},
doi = {10.11648/j.ijacm.20200802.18},
url = {https://doi.org/10.11648/j.ijacm.20200802.18},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20200802.18},
abstract = {Introduction: Regional analgesic techniques with infiltration of local anesthetic represent a cornerstone in modern postoperative pain management strategies after laparoscopic surgery. If used in a right concentration, it could help in attenuation of postoperative pain with better pulmonary performance and less morbidity. Aim: to compare the effect of different concentrations of intraperitoneal bupivacaine to obtain proper pain relief after laparoscopic bariatric surgery and evaluating its effect on pulmonary functions. Patients and methods: One hundred and twenty morbidly obese patients were included in this study. Patients were divided into three group. Group (A) patients received 50 ml bupivacaine 0.25% into the coelomic cavity. Group (B) patients receive 50 ml bupivacaine 0.125% into the coelomic cavity. Group (C) control group (n=36): patients receive 50 ml of normal saline into the coelomic cavity. VAS score and pulmonary function study were examined before and at regular intervals after surgery. Total analgesic requirements and time to first analgesic rescue was recorded. Results: VAS in group (A) was significantly lower than group (C) 2 hours after surgery and lower in group (A) compared with group (B&C) at 4 and 6 hours postoperative. Postoperative morphine consumption was lower in group (A) during the first 24 hours when compared to group (B & C) respectively. Both FVC and FEV1 were higher in group (A) compared to group (B&C) at 6hours postoperative. Conclusion: intraperitoneal injection of bupivacaine 0.25% is an efficient method of decreasing the postoperative pain with better preservation of pulmonary functions in morbidly obese patients undergoing laparoscopic bariatric surgery.},
year = {2020}
}
TY - JOUR T1 - Effect of Different Concentrations of Intraperitoneal Bupivacaine on Postoperative Outcome in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery AU - Mohammed Adel Hegazy AU - Hosam Hamed AU - Mohamed Said Salim AU - Mohamed Abdelraoof AU - Ahmed Mohamed Farid AU - Hani Taman Y1 - 2020/11/09 PY - 2020 N1 - https://doi.org/10.11648/j.ijacm.20200802.18 DO - 10.11648/j.ijacm.20200802.18 T2 - International Journal of Anesthesia and Clinical Medicine JF - International Journal of Anesthesia and Clinical Medicine JO - International Journal of Anesthesia and Clinical Medicine SP - 68 EP - 73 PB - Science Publishing Group SN - 2997-2698 UR - https://doi.org/10.11648/j.ijacm.20200802.18 AB - Introduction: Regional analgesic techniques with infiltration of local anesthetic represent a cornerstone in modern postoperative pain management strategies after laparoscopic surgery. If used in a right concentration, it could help in attenuation of postoperative pain with better pulmonary performance and less morbidity. Aim: to compare the effect of different concentrations of intraperitoneal bupivacaine to obtain proper pain relief after laparoscopic bariatric surgery and evaluating its effect on pulmonary functions. Patients and methods: One hundred and twenty morbidly obese patients were included in this study. Patients were divided into three group. Group (A) patients received 50 ml bupivacaine 0.25% into the coelomic cavity. Group (B) patients receive 50 ml bupivacaine 0.125% into the coelomic cavity. Group (C) control group (n=36): patients receive 50 ml of normal saline into the coelomic cavity. VAS score and pulmonary function study were examined before and at regular intervals after surgery. Total analgesic requirements and time to first analgesic rescue was recorded. Results: VAS in group (A) was significantly lower than group (C) 2 hours after surgery and lower in group (A) compared with group (B&C) at 4 and 6 hours postoperative. Postoperative morphine consumption was lower in group (A) during the first 24 hours when compared to group (B & C) respectively. Both FVC and FEV1 were higher in group (A) compared to group (B&C) at 6hours postoperative. Conclusion: intraperitoneal injection of bupivacaine 0.25% is an efficient method of decreasing the postoperative pain with better preservation of pulmonary functions in morbidly obese patients undergoing laparoscopic bariatric surgery. VL - 8 IS - 2 ER -
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