Effect of a Local Anesthetic Injection Kit on Pain Relief and Postoperative Recovery After Transumbilical Single-Incision Laparoscopic Cholecystectomy

Na Yang; Qing-Yu Tao; Jing-Yi Niu; Hao Sun; Yan He; Yong-Bo Hou; Hong Luo; Zhi Zhang; Jun-Ma Yu

doi:10.2147/JPR.S422454

Effect of a Local Anesthetic Injection Kit on Pain Relief and Postoperative Recovery After Transumbilical Single-Incision Laparoscopic Cholecystectomy

J Pain Res. 2023 Aug 11:16:2791-2801. doi: 10.2147/JPR.S422454. eCollection 2023.

Authors

Na Yang^#¹, Qing-Yu Tao^#¹, Jing-Yi Niu¹, Hao Sun¹, Yan He^{1

2}, Yong-Bo Hou^{1

2}, Hong Luo¹, Zhi Zhang³, Jun-Ma Yu¹

Affiliations

¹ Department of Anesthesiology, the Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, Anhui, People's Republic of China.
² Department of Anesthesiology, Wannan Medical College, Wuhu, Anhui, People's Republic of China.
³ Department of Biophysics and Neurobiology, University of Science and Technology of China, Hefei, Anhui, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: This study was conducted to explore whether incisional infiltration using a local anesthetic injection kit could better relieve postoperative pain and enhance the quality of recovery compared with ultrasound-guided rectus sheath block (RSB) or conventional local anesthetic infiltration in patients undergoing transumbilical single-incision laparoscopic cholecystectomy (SILC).

Patients and methods: A total of 60 patients undergoing SILC with American Society of Anesthesiology functional status scores of I-II were randomized into the rectus sheath block group (RSB group), conventional local wound infiltration group (LAI-I group) and incisional infiltration using a local anesthetic injection kit group (LAI-II group). The primary outcomes were the patient-controlled intravenous analgesia (PCIA) demand frequency within 48 hours after the operation and postoperative pain measured by a visual analog scale (VAS) at 2 h, 4 h, 8 h, 24 h, and 48 h after surgery. Secondary outcomes were the total procedure times, cumulative consumption of anesthetic drugs, duration of surgery, duration and awaking time of anesthesia, early recovery indicator and side effects.

Results: The PCIA demand frequency in LAI-II group was significantly lower compared with patients in the RSB and LAI-I group (both P < 0.001). Moreover, the total procedure times in LAI-I and LAI-II group was significantly shorter than that in the RSB group (P < 0.001, respectively), but it was comparable between LAI-I and LAI-II group (P = 0.471). Though lower at 2h and 4h postoperative in LAI-II group, pain scores at each time point had no statistical differences among three groups. There were no significant differences among three groups for other outcomes as well.

Conclusion: The effect of ultrasound-guided RSB and conventional local anesthetic infiltration in SILC patients were found to be similar in terms of relieving postoperative pain and promoting recovery. Incisional infiltration using a local anesthetic injection kit can significantly reduce the demand frequency of PCIA, which serves as a rescue analgesic.

Keywords: laparoscopic cholecystectomy; local infiltration analgesia; pain; recovery; rectus sheath block.

Grants and funding

This work was supported by the Applied Medicine Research Project Fund of Hefei Health Committee (grant number 2019-ZC-2) and Postgraduate Innovation Research and Practice Program of Anhui Medical University (grant number YJS20230088). The authors had full access to all data in the original study.