Intraperitoneal Meperidine Within Multimodal Analgesia Regimen for Pain Relief after Laparoscopic Upper-Abdominal Surgery
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- Category: Vol. 81, June 2013
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Intraperitoneal Meperidine Within Multimodal Analgesia Regimen for Pain Relief after Laparoscopic Upper-Abdominal Surgery,MOHAMED A. MAHMOUD
Abstract
Background: Although laparoscopic upper-abdominal surgery (LUAS) results in less pain than open surgery, it is not a pain-free procedure. Many methods of analgesia for pain after laparoscopy have been evaluated.
Aim of the Work: This randomized controlled trial assessing interventions to reduce pain after laparoscopic upper-abdominal surgery. Non-steroidal anti-inflammatory drugs, wound local anaesthetic, intraperitoneal bupivacaine local anaesthetic, intraperitoneal meperidine, a gas drain, heated gas, low-pressure gas pneumo-peritoneum have been shown to reduce pain after (LUAS).
Patients and Methods: 50 patients received 80mL of 1.25mg/kg bupivacaine with 1:400,000 epinephrine IP and 0.8mg/kg of meperidine either IP or IM.
Results: Postoperative pain scores were measured at rest and with movement. Pain scores were significantly lower in the group receiving the IP meperidine both at rest (p<0.01) and with movement (p<0.05). Pain after (LUAS) is multifac-torial.
Conclusion: Although many methods of analgesia produce short-term benefit, this does not equate with earlier discharge or improved postoperative function. However low-pressure insufflation, heated gas and combination of IP bupivacaine and meperidine within multimodal analgesia proved superior to equivalent doses of IP bupivacaine and IM meperidine for postoperative pain relief in patients undergoing laparoscopic surgery.