Nebulization of local anaesthetics in laparoscopic surgery: A new tool for postoperative analgesia

Pablo M. Ingelmo, Marta Somaini, Mario Bucciero, Massimo Allegri, Dario Bugada, Maria Cusato, Pierre Diemunsch

Research output: Contribution to journalArticle

Abstract

Laparoscopic procedures have been associated to moderate or severe pain that may require opioids and almost all patients referred shoulder pain. Intraperitoneal instillation of local anaesthetics, as part of a multimodal approach analgesia program, reduces pain intensity and morphine consumption after laparoscopic cholecystectomy. However, direct local anesthetic instillation is not enough to eliminate visceral and shoulder pain. Heated and humidified gas may produce positive effects such as reduction of postoperative pain. Intraperitoneal nebulization, a new technique of drug administration, provides homogeneous spread of drugs allowing a better distribution of local anaesthetics throughout the peritoneum. This technique combines the effects of gas conditioning and the analgesic benefits of local anaesthetic instillation. Nebulization of local anaesthetics during different laparoscopic procedures reduced postoperative pain, morphine consumption and allowed earlier mobilization. Future studies should determine, the optimal dose of local anaesthetics, the effect of local anaesthetic nebulization in different clinical settings and its importance on long term clinical outcomes.

Original languageEnglish
Pages (from-to)235-238
Number of pages4
JournalEuropean Journal of Pain Supplements
Volume4
Issue number4
DOIs
Publication statusPublished - Nov 2010

Keywords

  • Laparoscopic surgery
  • Multimodal analgesia
  • Nebulization
  • Postoperative pain
  • Visceral pain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Ingelmo, P. M., Somaini, M., Bucciero, M., Allegri, M., Bugada, D., Cusato, M., & Diemunsch, P. (2010). Nebulization of local anaesthetics in laparoscopic surgery: A new tool for postoperative analgesia. European Journal of Pain Supplements, 4(4), 235-238. https://doi.org/10.1016/j.eujps.2010.09.012