Intraoperative local anesthesia decreases postoperative parenteral opioid requirements for transperitoneal laparoscopic renal and adrenal surgery: a randomized, double-blind, placebo controlled investigation

The Journal of Urology
Herkanwal S Khaira, J Stuart Wolf

Abstract

To determine if local anesthesia decreases discomfort following laparoscopic upper retroperitoneal surgery, we performed a randomized, double-blind, placebo controlled study in which the port sites and hand assist incision were infiltrated with bupivacaine or placebo prior to surgery. A total of 72 patients undergoing transperitoneal laparoscopic renal or adrenal surgery were randomly assigned to the treatment (0.5% bupivacaine) or placebo (0.9% normal saline) arm. Port and hand assist port sites were infiltrated at the outset of the procedure. Postoperative pain and opioid use were measured at consistent intervals. A total of 37 individuals were treated with placebo (standard laparoscopy [SL] in 15 and hand assisted laparoscopy [HALS] in 22) and 35 were treated with bupivacaine (SL in 16 and HALS in 19). Mean parenteral morphine equivalents use for the placebo vs bupivacaine groups were 29.6 vs 20.0 mg at 12 hours, 50.2 vs 34.5 mg at 24 hours and 57.1 vs 36.6 mg for the total hospital stay (all p <0.05). Parenteral opioid use was decreased in the bupivacaine group in the SL and HALS subgroups with a significant effect at 12 hours in the latter subgroup. On multivariate ANOVA bupivacaine use but not SL vs HALS was associated wi...Continue Reading

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Citations

Mar 31, 2005·Journal of Endourology
Jan 18, 2011·Journal of Endourology·J Stuart Wolf
Nov 8, 2013·Journal of Anesthesia·George VretzakisMenelaos Karanikolas
Dec 6, 2011·Urology·Alon Z Weizer
Jun 12, 2010·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·N BerthonG Vallancien
Sep 25, 2015·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Altug TuncelAli Atan
Jul 26, 2005·Peptides·Richard J Bodnar, Gad E Klein
Dec 8, 2017·Obstetrics and Gynecology·Jennifer YeungRachel N Pauls
Dec 31, 2018·The Cochrane Database of Systematic Reviews·Alberto ArezzoMario Morino
Apr 16, 2021·Journal of Robotic Surgery·Laura HorodyskiLeslie A Deane

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