Effects of intraperitoneal lidocaine combined with intravenous or intraperitoneal tenoxicam on pain relief and bowel recovery after laparoscopic cholecystectomy
M. Elhakim et al., Effects of intraperitoneal lidocaine combined with intravenous or intraperitoneal tenoxicam on pain relief and bowel recovery after laparoscopic cholecystectomy, ACT ANAE SC, 44(8), 2000, pp. 929-933
Citations number
27
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Background: Previous work has demonstrated that intraperitoneal (i.p.) lido
caine may provide analgesia after laparoscopic cholecystectomy. The aim of
this prospective, randomized, double-blind study was to compare pain relief
, recovery variables, and side effects after i.p. instillation of lidocaine
plus tenoxicam given either i.v. or i.p. after laparoscopic cholecystectom
y.
Methods: Ninety patients were randomly allocated to one of three groups to
receive either 200 mi normal saline i.p. and 2 mi of normal saline i.v. (sa
line group), 200 mi lidocaine 0.1% i.p. and 2 mi tenoxicam 20 mg i.v. (teno
xicam i.v. group), or 200 mi lidocaine 0.1% with 20 mg tenoxicam i.p. and 2
mi of normal saline i.v. (tenoxicam i.p. group). The i.p. instillation was
made under the right diaphragm and on the gall bladder bed. VAS pain score
s at rest, on movement and during coughing, were measured 2, 4, 6, 12, and
24 h after operation. The time to first demand of analgesia, total analgesi
c requirement, recovery variables, and side effects were investigated.
Results: In the tenoxicam i.p. group, pain scores were significantly lower
both at rest and on movement and analgesic consumption was reduced compared
with the saline group (P<0.05). Zn the tenoxicam i.v. group, pain scores a
t rest were significantly lower compared with the saline group. Although re
covery of bowel function was significantly faster in the tenoxicam i.p. gro
up (P<0.05), there were no differences in any other recovery characteristic
s or incidence of nausea between the groups.
Conclusion: Combination of intraperitoneal lidocaine and tenoxicam provided
better analgesia on movement, and faster return of bowel function compared
with i.p. lidocaine and i.v. tenoxicam during the 24 h period after surger
y.