The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial

Background: The main goal of the present randomized clinical trial was to investigate the effects of subcutaneous administration of two different local anesthetics at trocar incision sites at the abdominal wall in combination with intraoperative intraperitoneal instillation of local anesthetics, on...

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Autores principales:	Zenon Pogorelić, Tea Gaberc, Miro Jukić, Goran Tintor, Ana Nevešćanin Biliškov, Ivana Mrklić, Ana Jerončić
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	local anesthetic pain varicocele adolescents laparoscopy Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/8f8c303c8aef4402b4a55f86f80dce7e
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spelling	oai:doaj.org-article:8f8c303c8aef4402b4a55f86f80dce7e2021-11-25T17:14:52ZThe Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial10.3390/children81110512227-9067https://doaj.org/article/8f8c303c8aef4402b4a55f86f80dce7e2021-11-01T00:00:00Zhttps://www.mdpi.com/2227-9067/8/11/1051https://doaj.org/toc/2227-9067Background: The main goal of the present randomized clinical trial was to investigate the effects of subcutaneous administration of two different local anesthetics at trocar incision sites at the abdominal wall in combination with intraoperative intraperitoneal instillation of local anesthetics, on the character of postoperative pain, in adolescents who underwent laparoscopic varicocelectomy. Methods: A total of 60 patients with a median age of 16 years, who received laparoscopic varicocele repair, were included in this randomized clinical trial. The patients were randomly assigned to three study groups receiving 2% lidocaine, 0.5% levobupivacaine, or the control group. The Visual Analogue Scale (VAS) was used by a blinded nurse at four different time points (2, 6, 12 and 24 h after the surgery) to measure pain intensity. Results: The significant effect of time on the pain intensity (<i>p</i> = 0.001) was found. Additionally, the interaction between time and different local analgesics (<i>p</i> < 0.001) was observed. In patients in whom 0.5% levobupivacaine has been used, significantly lower VAS pain scores were recorded at each time point assessed, in comparison with the patients who received 2% lidocaine or the patients from the control group in whom no local anesthetic was applied (<i>p</i> < 0.001). Furthermore, in patients in whom 2% lidocaine was administrated, significantly lower pain levels according to VAS were reported than in those from the control group, except for the time point at 24 h after surgery when pain levels were comparable. Concerning the postoperative pain control, the number of patients who requested oral analgesics postoperatively was significantly lower in the group of patients in whom local anesthetic was administrated intraoperatively (2% lidocaine—n = 4, 20%; 0.5% levobupivacaine—n = 1, 5%) compared to the patients who did not receive any local anesthetic during the surgery (n = 13; 65%) (<i>p</i> < 0.001). Conclusion: A significant reduction in postoperative pain intensity and analgesics consumption in patients undergoing laparoscopic varicocelectomy who received intraoperative local anesthetic was observed. The best effect on postoperative pain intensity, according to the VAS score, was achieved by 0.5% levobupivacaine.Zenon PogorelićTea GabercMiro JukićGoran TintorAna Nevešćanin BiliškovIvana MrklićAna JerončićMDPI AGarticlelocal anestheticpainvaricoceleadolescentslaparoscopyPediatricsRJ1-570ENChildren, Vol 8, Iss 1051, p 1051 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	local anesthetic pain varicocele adolescents laparoscopy Pediatrics RJ1-570
spellingShingle	local anesthetic pain varicocele adolescents laparoscopy Pediatrics RJ1-570 Zenon Pogorelić Tea Gaberc Miro Jukić Goran Tintor Ana Nevešćanin Biliškov Ivana Mrklić Ana Jerončić The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial
description	Background: The main goal of the present randomized clinical trial was to investigate the effects of subcutaneous administration of two different local anesthetics at trocar incision sites at the abdominal wall in combination with intraoperative intraperitoneal instillation of local anesthetics, on the character of postoperative pain, in adolescents who underwent laparoscopic varicocelectomy. Methods: A total of 60 patients with a median age of 16 years, who received laparoscopic varicocele repair, were included in this randomized clinical trial. The patients were randomly assigned to three study groups receiving 2% lidocaine, 0.5% levobupivacaine, or the control group. The Visual Analogue Scale (VAS) was used by a blinded nurse at four different time points (2, 6, 12 and 24 h after the surgery) to measure pain intensity. Results: The significant effect of time on the pain intensity (<i>p</i> = 0.001) was found. Additionally, the interaction between time and different local analgesics (<i>p</i> < 0.001) was observed. In patients in whom 0.5% levobupivacaine has been used, significantly lower VAS pain scores were recorded at each time point assessed, in comparison with the patients who received 2% lidocaine or the patients from the control group in whom no local anesthetic was applied (<i>p</i> < 0.001). Furthermore, in patients in whom 2% lidocaine was administrated, significantly lower pain levels according to VAS were reported than in those from the control group, except for the time point at 24 h after surgery when pain levels were comparable. Concerning the postoperative pain control, the number of patients who requested oral analgesics postoperatively was significantly lower in the group of patients in whom local anesthetic was administrated intraoperatively (2% lidocaine—n = 4, 20%; 0.5% levobupivacaine—n = 1, 5%) compared to the patients who did not receive any local anesthetic during the surgery (n = 13; 65%) (<i>p</i> < 0.001). Conclusion: A significant reduction in postoperative pain intensity and analgesics consumption in patients undergoing laparoscopic varicocelectomy who received intraoperative local anesthetic was observed. The best effect on postoperative pain intensity, according to the VAS score, was achieved by 0.5% levobupivacaine.
format	article
author	Zenon Pogorelić Tea Gaberc Miro Jukić Goran Tintor Ana Nevešćanin Biliškov Ivana Mrklić Ana Jerončić
author_facet	Zenon Pogorelić Tea Gaberc Miro Jukić Goran Tintor Ana Nevešćanin Biliškov Ivana Mrklić Ana Jerončić
author_sort	Zenon Pogorelić
title	The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial
title_short	The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial
title_full	The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial
title_fullStr	The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial
title_full_unstemmed	The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial
title_sort	effect of subcutaneous and intraperitoneal instillation of local anesthetics on postoperative pain after laparoscopic varicocelectomy: a randomized controlled trial
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8f8c303c8aef4402b4a55f86f80dce7e
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The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial

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