A randomized double blinded study to determine the effectiveness of utilizing intraperitoneal bupivacaine: Does it reduce postoperative opioid use following laparoscopic appendectomy?


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
03 2019
Historique:
received: 21 07 2018
revised: 28 10 2018
accepted: 30 10 2018
pubmed: 18 11 2018
medline: 21 11 2019
entrez: 18 11 2018
Statut: ppublish

Résumé

Improving postoperative pain control may lead to improved outcomes including decreased opioid use, shorter hospital stays, and improved patient satisfaction. This study examined the effects of instilling intraperitoneal bupivacaine following laparoscopic appendectomy. In this prospective, randomized, double-blinded, placebo-controlled study, patients with appendicitis were randomized to receive either the bupivacaine or normal saline instilled at the appendectomy site prior to close. Postoperative pain scores, opioid doses and length of stay were recorded. Pain scores were lower (mean 2.48 versus 3.8; p = 0.014), and postoperative opioid use was lower (mean 7.394 mg versus 16.921 mg; p = 0.007) in the bupivacaine group. Instilling bupivacaine at the base of the cecum at the conclusion of laparoscopic appendectomy was associated with reducing postoperative pain scores and in hospital opioid use. This prospective, randomized, double-blinded, placebo-controlled study enrolled subjects with acute appendicitis undergoing laparoscopic appendectomy. Subjects were randomized to receive either bupivacaine or normal saline intraperitoneally at the close of surgery. In the bupivacaine group, pain scores at 1 h were improved and inpatient postoperative opioid use was less.

Sections du résumé

BACKGROUND
Improving postoperative pain control may lead to improved outcomes including decreased opioid use, shorter hospital stays, and improved patient satisfaction. This study examined the effects of instilling intraperitoneal bupivacaine following laparoscopic appendectomy.
METHODS
In this prospective, randomized, double-blinded, placebo-controlled study, patients with appendicitis were randomized to receive either the bupivacaine or normal saline instilled at the appendectomy site prior to close. Postoperative pain scores, opioid doses and length of stay were recorded.
RESULTS
Pain scores were lower (mean 2.48 versus 3.8; p = 0.014), and postoperative opioid use was lower (mean 7.394 mg versus 16.921 mg; p = 0.007) in the bupivacaine group.
CONCLUSIONS
Instilling bupivacaine at the base of the cecum at the conclusion of laparoscopic appendectomy was associated with reducing postoperative pain scores and in hospital opioid use.
STATEMENT
This prospective, randomized, double-blinded, placebo-controlled study enrolled subjects with acute appendicitis undergoing laparoscopic appendectomy. Subjects were randomized to receive either bupivacaine or normal saline intraperitoneally at the close of surgery. In the bupivacaine group, pain scores at 1 h were improved and inpatient postoperative opioid use was less.

Identifiants

pubmed: 30446161
pii: S0002-9610(18)31011-0
doi: 10.1016/j.amjsurg.2018.10.045
pii:
doi:

Substances chimiques

Analgesics, Opioid 0
Anesthetics, Local 0
Bupivacaine Y8335394RO

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

479-482

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

Karlin Sevensma (K)

Metro Health University of Michigan Health, 5900 Byron Center, Wyoming, MI, 49519, USA. Electronic address: karlin.sevensma@metrogr.org.

Thomas Schleichert (T)

Metro Health University of Michigan Health, 5900 Byron Center, Wyoming, MI, 49519, USA.

Caroline Schwickerath (C)

Metro Health University of Michigan Health, 5900 Byron Center, Wyoming, MI, 49519, USA.

Alan Shoemaker (A)

Biostatistician Calvin College, Grand Rapids, MI, 40506, USA.

Clayton Miller (C)

Metro Health University of Michigan Health, 5900 Byron Center, Wyoming, MI, 49519, USA.

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Classifications MeSH