| Randomized, controlled trial of bupivacaine injection to decrease pain after laparoscopic cholecystectomy. | |
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MedLine Citation:
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PMID: 10459328 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To determine if intraoperative instillation of bupivacaine would decrease early postoperative pain after laparoscopic cholecystectomy, if the patients would consequently require less narcotic postoperatively and if such patients would elect to be discharged on the day of operation if given the choice. DESIGN: Double-blind, randomized, controlled trial. SETTING: A tertiary care hospital in Hamilton, Ont. PATIENTS: Fifty patients underwent laparoscopic cholecystectomy. Day-surgery patients had the choice of staying overnight for discharge the following day. They were compared with a control group of 47 patients who had laparoscopic cholecystectomy but did not receive bupivacaine. INTERVENTION: Instillation of 20 mL of 0.5% bupivacaine with epinephrine into laparoscopic cholecystectomy port sites intraoperatively before closure. MAIN OUTCOME MEASURES: Visual analogue scale (VAS) pain scores assessed 4 times postoperatively, the choice of patients to leave hospital the same day or to remain in the hospital overnight; the level of postoperative narcotic usage. MAIN RESULTS: Mean VAS pain scores (range 0 [no pain] to 5 [severe pain]) at less than 2 hours and at 6 hours after surgery were 2.9 and 2.9, respectively, in the bupivacaine group compared with 4.5 and 4.0, respectively, in the control group (p = 0.001 and 0.025). VAS scores at 10 hours postoperatively and the next morning did not differ between the groups. More patients in the bupivacaine group elected to go home on the day of surgery (p = 0.034). Narcotic usage was not significantly different. CONCLUSION: Instillation of bupivacaine into port sites should be standard practice for elective laparoscopic cholecystectomy. |
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Authors:
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D Dath; A E Park |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Canadian journal of surgery. Journal canadien de chirurgie Volume: 42 ISSN: 0008-428X ISO Abbreviation: Can J Surg Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-09-09 Completed Date: 1999-09-09 Revised Date: 2007-08-16 |
Medline Journal Info:
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Nlm Unique ID: 0372715 Medline TA: Can J Surg Country: CANADA |
Other Details:
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Languages: eng Pagination: 284-8 Citation Subset: IM |
Affiliation:
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Department of Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ont. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anesthetics, Local* / administration & dosage Bupivacaine* / administration & dosage Cholecystectomy, Laparoscopic* Double-Blind Method Female Humans Injections Male Middle Aged Pain Measurement Pain, Postoperative / prevention & control* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Local; 2180-92-9/Bupivacaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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