Elsevier

The Lancet

Volume 338, Issues 8782–8783, 28 December 1991, Pages 1569-1570
The Lancet

CLINICAL PRACTICE
Intraperitoneal local anaesthetic for shoulder pain after day-case laparoscopy

https://doi.org/10.1016/0140-6736(91)92384-EGet rights and content

Abstract

Laparoscopy is frequently associated with postoperative shoulder pain that may last several days. We have assessed the analgesic effect of intraperitoneal local anaesthetics during day-case diagnostic laparoscopy. 80 young women were randomly assigned to one of four groups of 20 patients each: group 1, no peritoneal administration; group 2, 80 ml saline injected under direct vision in the right subdiaphragmatic area at the start of the procedure; group 3, 80 ml 0·5% lignocaine with adrenaline (320 000 dilution); group 4, 0·125% bupivacaine with adrenaline (800 000 dilution). Scapular pain was assessed with a visual analogue pain scale, and information about nausea, vomiting, abdominal pain, and analgesic requirements during the first 48 h was sought. Both local anaesthetics were more effective in reducing postoperative shoulder pain than either control or saline. Analgesic requirements were greater in the non-treatment groups than in the local anaesthetic groups. Intraperitoneal local anaesthetic administration during laparoscopy is both a non-invasive and an efficient method of reducing the intensity of scapular pain.

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