The trocar insertion sites are infiltrated before the skin incision is made. Using the Lap-Assist Transversus Abdominis Plane Block Technique, the total volume of infiltrated 0.5% Levobupivacaine is 20 ml, divided proportionally according to the length of the skin incision.

The control group will not receive any local infiltrative agent.

Laparoscopic Colorectal Surgery

Colorectal Cancer

The infiltration group will receive local infiltration with 0.5% Levobupivacaine. The trocar insertion sites are infiltrated before the skin incision is made. Using the Lap-Assist Transversus Abdominis Plane Block Technique, the total volume of infiltrated 0.5% Levobupivacaine is 20 ml, divided proportionally according to the length of the skin incision (2 ml for the 5-mm trocar and 3 ml for the 10-mm trocars, and 10 mL for specimen retrieval incision). The specimen retrieval incision will be performed in one of two techniques, depending on the surgeon's preference, a 4-6 cm length midline incision (extending from the Hasson trocar incision) or a 4-6 cm length Pfanensteil incision.

0.5% Levobupivacaine

Control

Chairat Supsamutchai

Local Wound Infiltration With 0.5% Levobupivacaine for Postoperative Pain After Laparoscopic Colorectal Surgery.

A Prospective Randomized Controlled Trial of Postoperative Analgesic Effects of Local Wound Infiltration With 0.5% Levobupivacaine in Laparoscopic Colorectal Surgery.

After the operation, the inpatient ward nurse will record the patients' pain score at 4 hours after surgery using the VAS score and record the results in the study data recording form attached to each patient's medical record chart.standardized plan for postoperative analgesia is prepared. All patients will receive one 500 mg tablet of oral paracetamol every 6 hours when postoperative oral intake is allowed by the attending doctor. In patients with VAS scores >3, parenteral opioid (Morphine) is given.

The secondary objective is to compare the VAS scores between the two types of technique used for specimen retrieval incision.. The specimen retrieval incision will be performed in one of two techniques, depending on the surgeon's preference, a 4-6 cm length midline incision (extending from the Hasson trocar incision) or a 4-6 cm length Pfanensteil incision.

Mahidol University

Ramathibodi Hospital

The infiltration group will receive local infiltration with 0.5% Levobupivacaine. The trocar insertion sites are infiltrated before the skin incision is made. Using the Lap-Assist Transversus Abdominis Plane Block Technique, the total volume of infiltrated 0.5% Levobupivacaine is 20 ml, divided proportionally according to the length of the skin incision (2 ml for the 5-mm trocar and 3 ml for the 10-mm trocars, and 10 mL for specimen retrieval incision). The control group will not receive any local infiltrative agent.

Decrease Post Laproscopy Shoulder and Abdominal Pain

as the selected surgery is diagnostic laparoscopy done only for female as this type of surgery there will be no source of pain other than abdominal distension

the investigator prepares syringes 1.75 ml/kg of 0.2% lidocaine (3.5 mg/kg) or the same volume of normal saline, for intraperitoneal administration. The solution to be instillated will be splashed under the right diaphragmatic area by the surgeon and complete the procedure.

Intraperitoneal lidocaine

pulmonary recruitment maneuver will be done and consist of five manual pulmonary inflations with a maximum pressure of 40 cm H2O. The anestheiologist hold the fifth positive pressure inflation for approximately 5 seconds

Pulmonary Recruitment

the investigator prepares syringes 1.75 ml/kg of 0.2% lidocaine (3.5 mg/kg) or the same volume of normal saline, for intraperitoneal administration. The solution to be instillated will be splashed under the right diaphragmatic area by the surgeon and complete the procedure before the recovery of the patient pulmonary recruitment maneuver will be done and consist of five manual pulmonary inflations with a maximum pressure of 40 cm H2O. The anestheiologist hold the fifth positive pressure inflation for approximately 5 seconds

Combined intraperitoneal lidocaine and pulmonary recruitment maneuver

Faculty of medicine CAIRO UNIVERISTY

Multimodal Analgesic Technique for Control of Post-laproscopy Abdominal Pain

Multimodal Analgesic Technique for Control of Post-laproscopy Abdominal Pain in Patient Undergoing Diagnostic Gynacological Laproscopy. A Randomized Controlled Trial

post-operative pain measured using Visual Analogue Scale ,The patients were asked to complete a 10-cm linear analogue scale for shoulder pain, which ranged from 0 for no pain at all to 10 for the worst pain imaginable

questionnaire will done for the patient at 8, 10 hour using VAS

Sherin Refaat

lecturer of Anesthiology at faculty of medicine Cairo univeristy

Cairo University

Postoperative Pain

ADMINISTRATION OF STUDY DRUG All surgical port sites will be injected with 2 ml/each study drug prior to trocar insertion
Immediately following insufflation the Optispray surgical spray device will be inserted into the abdomen and directed towards the diaphragms, dome of inflated abdomen, bowel peritoneum and surgical dissection site and the study drug will be delivered as an atomized spray in the following volumes:
each subdiaphragmatic area 3.5 ml + 3.5ml
surgical dissection site 3 ml
diffusely across the peritoneal surface (dome of the abdomen and surface of the visible bowel) 7 ml. At the end of the case the remaining medication with be atomized again onto the same areas, using the same volumes.
At the end of the case - this process will be repeated with the remaining drug (no repeat port site injections).

Ropivacaine

ADMINSTRATION OF PLACEBO All surgical port sites will be injected with 2 ml/each placebo prior to trocar insertion
Immediately following insufflation the Optispray surgical spray device will be inserted into the abdomen and directed towards the diaphragms, dome of inflated abdomen, bowel peritoneum and surgical dissection site and the placebo will be delivered as an atomized spray in the following volumes:
each subdiaphragmatic area 3.5 ml + 3.5ml
surgical dissection site 3 ml
diffusely across the peritoneal surface (dome of the abdomen and surface of the visible bowel) 7 ml. At the end of the case the remaining placebo with be atomized again onto the same areas, using the same volumes.
At the end of the case - this process will be repeated with the remaining placebo (no repeat port site injections).

placebo (normal saline)

Azienda Ospedaliera-Università Padova

Intraperitoneal Atomization of Ropivacaine During Gynecologic Laparoscopic Surgery

Intraperitoneal Atomization of Ropivacaine During Gynecologic Laparoscopic Surgery: Impact on Pain, Opioid Use and Length of Recovery Room Stay

NRS score. (NRS; 0 = no pain and 10 = worse pain possible)at 6 hours post-operatively

University of Padova

Combination of acetaminophen, nitrous oxide, nefopam, morphine

Sickle Cell Anemia

Oral treatment :
1 gr Acetaminophen 20 mg of nefopam delivered on a lump sugar Nitrous oxide inhalation with initial output of 9 L/min subsequently Intravenous morphine bolus of 3 mg Nitrous oxide interruption after 5 minutes of the initial morphine bolus

Rapid optimized analgesic strategy

paracetamol 1 g per os nasal oxygen therapy
1 amp of morphine 10 mg / 10 cc of glucose 5 %, by repeated bolus administration

current analgesic strategy

Henri Mondor Hospital, Emergency Department

Effectiveness of New Analgesic Strategy Compared to the Usal Antalgic Strategy

New Analgesic Strategy Combining Nitrous Oxide, Nefopam, Acetaminophen and Morphine Compared to the Usal Antalgic Strategy (Acetaminophen and Morphine) for the Treatment of Acute Sickle Cell Disease Pain in the Emergency Room

pneumoperitoneum/ataque epiléptico

Local Wound Infiltration With 0.5% Levobupivacaine for Postoperative Pain After Laparoscopic Colorectal Surgery.

Multimodal Analgesic Technique for Control of Post-laproscopy Abdominal Pain

Intraperitoneal Atomization of Ropivacaine During Gynecologic Laparoscopic Surgery

Effectiveness of New Analgesic Strategy Compared to the Usal Antalgic Strategy

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