Surgical laparoscopy & endoscopy
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Surg Laparosc Endosc · Dec 1998
Randomized Controlled Trial Comparative Study Clinical TrialIntraperitoneal normal saline and bupivacaine infusion for reduction of postoperative pain after laparoscopic cholecystectomy.
After laparoscopic cholecystectomy, CO2 remains within the peritoneal cavity, commonly causing pain. This prospective randomized study was performed to determine the efficacy of intraperitoneal normal saline and bupivacaine infusion on postoperative pain after laparoscopic cholecystectomy. Three hundred patients were randomly assigned to one of six groups of 50 patients each. ⋯ Postoperative pain was reduced significantly in the patients of the treatment groups vs. the controls. Between treatment groups, patients in groups B, E, and F had the best results, while those in groups C and D had significantly greater pain than those in groups B, E, and F. It is concluded that postoperative pain after laparoscopic cholecystectomy can be significantly reduced by intraperitoneal normal saline infusion subdiaphragmatically and after its postdeflation suction, bupivacaine infusion in the same area, or without bupivacaine in case a subhepatic drainage has been needed.
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Surg Laparosc Endosc · Dec 1998
Randomized Controlled Trial Comparative Study Clinical TrialStress hyperglycemia in minimally invasive surgery.
This study examined the selected hormonal responses to, and hormone-mediated glucose metabolism during minimally invasive surgery in, patients undergoing laparoscopic cholecystectomy for symptomatic gallstone disease. Thirty-two patients with symptomatic gallstone disease were included in this study and scheduled for open or laparoscopic procedure in a randomized trial. Results are expressed as mean and standard error of the mean. ⋯ The glucagon-mediated increase in hepatic glucose production is excluded by the posttraumatic insulin levels from the insulin-sensitive tissues. A bihormonal setting favors a greater rate of hepatic glucose production in both open and laparoscopic surgery. Hormonal changes do reflect the degree of surgical stress, but their metabolic consequences are not parallel to the grade of surgical trauma in minimally invasive surgery.