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Intraperitoneal local anaesthetic in abdominal surgery – a systematic review
Article first published online: 17 NOV 2010
DOI: 10.1111/j.1445-2197.2010.05573.x
© 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons
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How to Cite
Kahokehr, A., Sammour, T., Soop, M. and Hill, A. G. (2011), Intraperitoneal local anaesthetic in abdominal surgery – a systematic review. ANZ Journal of Surgery, 81: 237–245. doi: 10.1111/j.1445-2197.2010.05573.x
Publication History
- Issue published online: 21 MAR 2011
- Article first published online: 17 NOV 2010
- Accepted for publication 17 May 2010.
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Keywords:
- intraperitoneal;
- local anaesthetic;
- pain;
- surgery;
- viscera
Abstract
Background: The use of intraperitoneal local anaesthetic (IPLA) can be used to modulate visceral nociception after abdominal surgery; however, this technique is not routinely used in open abdominal surgery. The aim of this systematic review was to appraise the clinical effects of IPLA in open abdominal surgery for metachronous outcomes including pain, metabolic response to surgery and gastrointestinal function.
Methods: A comprehensive search was conducted independently without language restriction. Relevant meeting abstracts and reference lists were manually searched. Data analysis was performed using Review Manager Version 5.0 software. Post-operative clinical and metabolic outcomes of randomized controlled trials comparing IPLA versus no IPLA or placebo solution were used for meta-analysis.
Results: Twelve trials were identified including eight randomized trials in gastrointestinal and gynaecological surgery. Post-operative pain was reduced but not opioid use. There was blunting of postoperative hyperglycaemia. There was no difference in post-operative cortisol response. Return of bowel function appeared to be quickened, although meta-analysis was not possible.
Conclusion: The use of IPLA is safe and appears to have clinical benefits. However this technique has not been studied in optimized perioperative settings. Trials are needed to evaluate this method of visceral blockade further after major abdominal surgery.