George Dejeu, Adrian M Maghiar, Octavian Maghiar, Dan Ciurtin, Marius Sfirlea, Codruta Macovei, Mihai Botea, Cipri Puscas, Calina Tarau, Erika Bimbo-Szuhai, Rodica Gilau, Paula Badea, Florin Fasie. Spital Pelican
In our institution, Surgery Clinic, Pelican Hospital in Oradea, Romania, we started studying the effect of using local anesthesia at the trocar sites at time of closure for basic, routine lap surgery. We started a prospective study including all patients with laparoscopic cholecystectomy and appendectomy in the past 3 months. We compared this group of patients with a matched group for age, sex, diagnosis, comorbidities and previous chronic medication from 12 months ago. We used a standardised surgical approach and postop management with the only difference being the addition of local anesthesia infiltrations of trocar sites at time of closure. To compare the effect on pain management we compared the pain score cards our patients routinely complete at 3, 6, 12 and 24 hours after this type of surgery. The extra pain medication needed was also noted, as was the use of opioids for pain management. We found the reduction of pain score at 3 and 6 hours (statistically significant) and reduction of opioid use (by 80%). The pain score at 12 and 24 hours show a reduction in pain for the local anesthesia gorup, but not statistically significant. We also noted the reduction of hospital stay from 4 to 3 days for the local anesthesia group, but this aspect was not in our end points for the study. We are currently implementing into our standard approach to all surgery the use of local anesthesia at the surgery site at time of closure, and are researching the use of nerve block techniques and use of continuous intravenous local anesthesia for pain management for our major surgery patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95925
Program Number: P648
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster