Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial
| Autor: | Nikolaos Benetatos, Paraskevi Mavridou, George Pappas-Gogos, Evangelos C. Tsimoyiannis, Charalampos Farantos, Konstantinos E. Tsimogiannis, Adamantia Manataki |
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| Rok vydání: | 2009 |
| Předmět: |
Laparoscopic surgery
Adult Male medicine.medical_specialty Abdominal pain medicine.medical_treatment law.invention Randomized controlled trial Double-Blind Method law medicine Humans Prospective Studies Laparoscopy Aged Pain Measurement Pain Postoperative medicine.diagnostic_test Umbilicus business.industry Gallbladder General surgery Middle Aged Surgery Endoscopy medicine.anatomical_structure Cholecystectomy Laparoscopic Cholecystectomy Female medicine.symptom business Abdominal surgery |
| Zdroj: | Surgical endoscopy. 24(8) |
| ISSN: | 1432-2218 |
| Popis: | The attempt to further reduce operative trauma in laparoscopic cholecystectomy has led to new techniques such as natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS). These new techniques are considered to be painless procedures, but no published studies investigate the possibility of different pain scores in these new techniques versus classic laparoscopic cholecystectomy. In this randomized control study, we investigated pain scores in SILS cholecystectomy versus classic laparoscopic cholecystectomy.Forty patients (34 women and 6 men) were randomly assigned to two groups. In group A (n = 20) four-port classic laparoscopic cholecystectomy was performed. Patients in group B (n = 20) underwent SILS cholecystectomy. In all patients, preincisional local infiltration of ropivacaine around the trocar wounds was performed. Infusion of ropivacaine solution in the right subdiaphragmatic area at the beginning of the procedure plus normal saline infusion in the same area at the end of the procedure was performed in all patients as well. Shoulder tip and abdominal pain were registered at 2, 6, 12, 24, 48, and 72 h postoperatively using visual analog scale (VAS).Significantly lower pain scores were observed in the SILS group versus the classic laparoscopic cholecystectomy group after the first 12 h for abdominal pain, and after the first 6 h for shoulder pain. Total pain after the first 24 h was nonexistent in the SILS group. Also, requests for analgesics were significantly less in the SILS group, while no difference was observed in incidence of nausea and vomiting between the two groups.SILS cholecystectomy, as well as the invisible scar, has significantly lower abdominal and shoulder pain scores, especially after the first 24 h postoperatively, when this pain is nonexistent. (Registration Clinical Trial number: NTC00872287, www.clinicaltrials.gov ). |
| Databáze: | OpenAIRE |
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