Application of intraperitoneal administration in the treatment of postoperative pain after laparoscopic cholecystectomy / 中国医师进修杂志

ABSTRACT

Laparoscopic cholecystectomy (LC) patients showed mild to moderate pain, non steroidal anti-inflammatory drugs (NSAIDS), opioids and antiepileptic drugs are used in routine treatment of postoperative pain in clinic. Although these drugs worked quickly, their adverse effects, such as drowsiness, post-operative nausea and vomiting (PONV), constipation and respiratory inhibition can lead to delayed discharge. Therefore, many researchers study the replacement treatment of postoperative pain. Pain after LC can be divided into superficial incision pain, deep visceral pain and shoulder referred pain. The species of drug are local anesthetics, steroid, tramadol and dexmedetomidine. There are 3 main types intraperitoneal administration time before the establishment of pneumoperitoneum, at the time of pneumoperitoneum and immediately after removal of the gallbladder. Intraperitoneal administration is often applied to the fossa of gallbladder, liver diaphragm, liver and diaphragm gap or the sites near the hepatoduodenal ligament. The main methods of intraperitoneal administration are instillation, infiltration, spraying and flushing. Based on many studies, it is beneficial to use intraperitoneal administration in terms of pain reduction in the early stage after LC. The use of intraperitoneal administration could reduce the amount of analgesic and mitigate the associated complications.