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document
Post-laparoscopic cholecystectomy pain : effects of intraperitoneal local anesthetics on pain control -- a randomized prospective double-blinded placebo-controlled trial . Postoperative pain after laparoscopic cholecystectomy ( LC ) is generally less than open cholecystectomy ; however , the postoperative shoulder and abdominal pain experienced by patients still causes preventable distress . Intraperitoneal irrigation of the diaphragmatic surface and gallbladder fossa using normal saline , bupivacaine , or lignocaine may effectively control visceral abdominal pain after an LC . Two hundred patients with similar demographics undergoing elective LC were randomized to one of four groups of 50 patients each , including Group A placebo control , Group B with isotonic saline irrigation , Group C with bupivacaine irrigation , and Group D with lignocaine irrigation . All patients received preperitoneal abdominal wall infiltration with 0.25 per cent bupivacaine to control parietal ( somatic ) abdominal pain . The visual analogue and verbal rating pain scores at 0 , 4 , 8 , 12 and 24 hours for both shoulder and abdominal pain were recorded in a prospective double-blind fashion at four points during the first 24 postoperative hours . Analgesia requirements , vital signs , blood glucose , and incidence of nausea and vomiting were also recorded . Patients in each group demonstrated a significant difference in visual analogue and verbal rating pain scores and analgesic consumption when compared with controls . Lignocaine controlled pain significantly better than saline or bupivacaine . Bowel function recovery was similar in all patients , and there were no significant complications . We conclude that intraperitoneal irrigation with either saline , bupivacaine , or lignocaine can significantly reduce visceral abdominal pain after LC . Lignocaine was the most efficacious local anesthetic in this trial and has a high safety profile when used at recommended doses .
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Intervention_Physical
anesthetics
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Intervention_Pharmacological
saline , bupivacaine
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Intervention_Pharmacological
lignocaine
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Intervention_Control
placebo
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Intervention_Pharmacological
isotonic saline irrigation
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Intervention_Pharmacological
bupivacaine irrigation
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Intervention_Pharmacological
lignocaine irrigation
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Intervention_Pharmacological
bupivacaine
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Intervention_Pharmacological
saline
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Outcome_Other
effects
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Outcome_Pain
visceral abdominal pain
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Outcome_Pain
visual analogue
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Outcome_Other
and
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Outcome_Pain
verbal rating pain scores
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Outcome_Physical
Analgesia requirements , vital signs , blood glucose , and incidence of nausea and vomiting
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Outcome_Pain
visual analogue and verbal rating pain scores
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Outcome_Other
analgesic consumption
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Outcome_Pain
controlled pain
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Outcome_Physical
Bowel function recovery
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Outcome_Pain
visceral abdominal pain
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Participant_Condition
Post-laparoscopic cholecystectomy pain
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Participant_Condition
Postoperative pain after laparoscopic cholecystectomy ( LC )
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Participant_Sample-size
Two hundred
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Participant_Sample-size
four groups of 50 patients each
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Participant_Condition
parietal ( somatic ) abdominal pain