Pain related to robotic cholecystectomy with lower abdominal ports: effect of the bilateral ultrasound-guided split injection technique of rectus sheath block in female patients: A prospective randomised trial
Robotic cholecystectomy (RC) using port sites in the lower abdominal area (T12-L1) rather than the upper abdomen has recently been introduced as an alternative procedure for laparoscopic cholecystectomy. Therefore, we investigated the time course of different components of pain and the analgesic eff...
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| Veröffentlicht in: | Medicine (Baltimore) 2016-08, Vol.95 (31), p.e4445-e4445 |
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| creator | Kim, Jin Soo Choi, Jong Bum Lee, Sook Young Kim, Wook Hwan Baek, Nam Hyun Kim, Jayoun Park, Chu Kyung Lee, Yeon Ju Park, Sung Yong |
| description | Robotic cholecystectomy (RC) using port sites in the lower abdominal area (T12-L1) rather than the upper abdomen has recently been introduced as an alternative procedure for laparoscopic cholecystectomy. Therefore, we investigated the time course of different components of pain and the analgesic effect of the bilateral ultrasound-guided split injection technique for rectus sheath block (sRSB) after RC in female patients.
We randomly assigned 40 patients to undergo ultrasound-guided sRSB (RSB group, n = 20) or to not undergo any block (control group, n = 20). Pain was subdivided into 3 components: superficial wound pain, deep abdominal pain, and referred shoulder pain, which were evaluated with a numeric rating scale (from 0 to 10) at baseline (time of awakening) and at 1, 6, 9, and 24 hours postoperatively. Consumption of fentanyl and general satisfaction were also evaluated 1 hour (before discharge from the postanesthesia care unit) and 24 hours postoperatively (end of study).
Superficial wound pain was predominant only at awakening, and after postoperative 1 hour in the control group. Bilateral ultrasound-guided sRSB significantly decreased superficial pain after RC (P |
| doi_str_mv | 10.1097/MD.0000000000004445 |
| format | Article |
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We randomly assigned 40 patients to undergo ultrasound-guided sRSB (RSB group, n = 20) or to not undergo any block (control group, n = 20). Pain was subdivided into 3 components: superficial wound pain, deep abdominal pain, and referred shoulder pain, which were evaluated with a numeric rating scale (from 0 to 10) at baseline (time of awakening) and at 1, 6, 9, and 24 hours postoperatively. Consumption of fentanyl and general satisfaction were also evaluated 1 hour (before discharge from the postanesthesia care unit) and 24 hours postoperatively (end of study).
Superficial wound pain was predominant only at awakening, and after postoperative 1 hour in the control group. Bilateral ultrasound-guided sRSB significantly decreased superficial pain after RC (P < 0.01) and resulted in a better satisfaction score (P < 0.05) 1 hour after RC in the RSB group compared with the control group. The cumulative postoperative consumption of fentanyl at 6, 9, and 24 hours was not significantly different between groups.
After RC with lower abdominal ports, superficial wound pain predominates over deep intra-abdominal pain and shoulder pain only at the time of awakening. Afterwards, superficial and deep pain decreased to insignificant levels in 6 hours. Bilateral ultrasound-guided sRSB was effective only during the first hour. This limited benefit should be balanced against the time and risks entailed in performing RSB.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000004445</identifier><identifier>PMID: 27495072</identifier><language>eng</language><publisher>United States: The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Aged ; Anesthetics, Local - administration & dosage ; Cholecystectomy, Laparoscopic - adverse effects ; Cholecystectomy, Laparoscopic - methods ; Clinical Trial/Experimental Study ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Nerve Block - methods ; Pain Measurement ; Pain, Postoperative - prevention & control ; Prospective Studies ; Rectus Abdominis - drug effects ; Risk Assessment ; Robotic Surgical Procedures - adverse effects ; Robotic Surgical Procedures - methods ; Robotics ; Single-Blind Method ; Treatment Outcome ; Ultrasonography, Interventional - methods</subject><ispartof>Medicine (Baltimore), 2016-08, Vol.95 (31), p.e4445-e4445</ispartof><rights>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3558-9ba8cf87f401b0ed492fa962990b644a1198515ef48146040eeedd8e05db35343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979826/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979826/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27495072$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Jin Soo</creatorcontrib><creatorcontrib>Choi, Jong Bum</creatorcontrib><creatorcontrib>Lee, Sook Young</creatorcontrib><creatorcontrib>Kim, Wook Hwan</creatorcontrib><creatorcontrib>Baek, Nam Hyun</creatorcontrib><creatorcontrib>Kim, Jayoun</creatorcontrib><creatorcontrib>Park, Chu Kyung</creatorcontrib><creatorcontrib>Lee, Yeon Ju</creatorcontrib><creatorcontrib>Park, Sung Yong</creatorcontrib><title>Pain related to robotic cholecystectomy with lower abdominal ports: effect of the bilateral ultrasound-guided split injection technique of rectus sheath block in female patients: A prospective randomised trial</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>Robotic cholecystectomy (RC) using port sites in the lower abdominal area (T12-L1) rather than the upper abdomen has recently been introduced as an alternative procedure for laparoscopic cholecystectomy. Therefore, we investigated the time course of different components of pain and the analgesic effect of the bilateral ultrasound-guided split injection technique for rectus sheath block (sRSB) after RC in female patients.
We randomly assigned 40 patients to undergo ultrasound-guided sRSB (RSB group, n = 20) or to not undergo any block (control group, n = 20). Pain was subdivided into 3 components: superficial wound pain, deep abdominal pain, and referred shoulder pain, which were evaluated with a numeric rating scale (from 0 to 10) at baseline (time of awakening) and at 1, 6, 9, and 24 hours postoperatively. Consumption of fentanyl and general satisfaction were also evaluated 1 hour (before discharge from the postanesthesia care unit) and 24 hours postoperatively (end of study).
Superficial wound pain was predominant only at awakening, and after postoperative 1 hour in the control group. Bilateral ultrasound-guided sRSB significantly decreased superficial pain after RC (P < 0.01) and resulted in a better satisfaction score (P < 0.05) 1 hour after RC in the RSB group compared with the control group. The cumulative postoperative consumption of fentanyl at 6, 9, and 24 hours was not significantly different between groups.
After RC with lower abdominal ports, superficial wound pain predominates over deep intra-abdominal pain and shoulder pain only at the time of awakening. Afterwards, superficial and deep pain decreased to insignificant levels in 6 hours. Bilateral ultrasound-guided sRSB was effective only during the first hour. This limited benefit should be balanced against the time and risks entailed in performing RSB.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthetics, Local - administration & dosage</subject><subject>Cholecystectomy, Laparoscopic - adverse effects</subject><subject>Cholecystectomy, Laparoscopic - methods</subject><subject>Clinical Trial/Experimental Study</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Nerve Block - methods</subject><subject>Pain Measurement</subject><subject>Pain, Postoperative - prevention & control</subject><subject>Prospective Studies</subject><subject>Rectus Abdominis - drug effects</subject><subject>Risk Assessment</subject><subject>Robotic Surgical Procedures - adverse effects</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotics</subject><subject>Single-Blind Method</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Interventional - methods</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUstu1TAQjRCIXgpfgIS8ZJNiJ3Zis0Cq2vKQWsEC1pbjTBq3vnGwnV7dz-SPmHBLVfDG0syZc848iuI1oyeMqvbd1fkJffQ45-JJsWGibkqhGv602FBaibJVLT8qXqR0Qymr24o_L46qlitB22pT_Ppm3EQieJOhJzmQGLqQnSV2DB7sPmWwOWz3ZOfySHzYQSSm68PWTcaTOcSc3hMYBkSRMJA8AuncShYxvfgcTQrL1JfXi-tRIM3eZeKmG8S7MBFkHyf3c4G1OGJwSSSNYFCr88HeIpQMsDUeyGyyg2mVOyVzDGleKe6ARDOtdtJqPzrjXxbPBuMTvLr_j4sfHy--n30uL79--nJ2elnaWghZqs5IO8h24JR1FHquqsGoplKKdg3nhjElBRMwcMl4QzkFgL6XQEXf1aLm9XHx4cA7L90WeovesGc9R7c1ca-DcfrfzORGfR3uNFetklWDBG_vCWLACaSssQsL3psJwpI0k1StwpIitD5ALTaeIgwPMozq9Rj01bn-_xiw6s1jhw81f7ePAH4A7ILHjaVbv-B-Nc7f5_EPn2hVVVaUNeiiouUakfVv53rGKA</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Kim, Jin Soo</creator><creator>Choi, Jong Bum</creator><creator>Lee, Sook Young</creator><creator>Kim, Wook Hwan</creator><creator>Baek, Nam Hyun</creator><creator>Kim, Jayoun</creator><creator>Park, Chu Kyung</creator><creator>Lee, Yeon Ju</creator><creator>Park, Sung Yong</creator><general>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</general><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160801</creationdate><title>Pain related to robotic cholecystectomy with lower abdominal ports: effect of the bilateral ultrasound-guided split injection technique of rectus sheath block in female patients: A prospective randomised trial</title><author>Kim, Jin Soo ; Choi, Jong Bum ; Lee, Sook Young ; Kim, Wook Hwan ; Baek, Nam Hyun ; Kim, Jayoun ; Park, Chu Kyung ; Lee, Yeon Ju ; Park, Sung Yong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3558-9ba8cf87f401b0ed492fa962990b644a1198515ef48146040eeedd8e05db35343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthetics, Local - administration & dosage</topic><topic>Cholecystectomy, Laparoscopic - adverse effects</topic><topic>Cholecystectomy, Laparoscopic - methods</topic><topic>Clinical Trial/Experimental Study</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Nerve Block - methods</topic><topic>Pain Measurement</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Prospective Studies</topic><topic>Rectus Abdominis - drug effects</topic><topic>Risk Assessment</topic><topic>Robotic Surgical Procedures - adverse effects</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotics</topic><topic>Single-Blind Method</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Interventional - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Jin Soo</creatorcontrib><creatorcontrib>Choi, Jong Bum</creatorcontrib><creatorcontrib>Lee, Sook Young</creatorcontrib><creatorcontrib>Kim, Wook Hwan</creatorcontrib><creatorcontrib>Baek, Nam Hyun</creatorcontrib><creatorcontrib>Kim, Jayoun</creatorcontrib><creatorcontrib>Park, Chu Kyung</creatorcontrib><creatorcontrib>Lee, Yeon Ju</creatorcontrib><creatorcontrib>Park, Sung Yong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Jin Soo</au><au>Choi, Jong Bum</au><au>Lee, Sook Young</au><au>Kim, Wook Hwan</au><au>Baek, Nam Hyun</au><au>Kim, Jayoun</au><au>Park, Chu Kyung</au><au>Lee, Yeon Ju</au><au>Park, Sung Yong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pain related to robotic cholecystectomy with lower abdominal ports: effect of the bilateral ultrasound-guided split injection technique of rectus sheath block in female patients: A prospective randomised trial</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>95</volume><issue>31</issue><spage>e4445</spage><epage>e4445</epage><pages>e4445-e4445</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>Robotic cholecystectomy (RC) using port sites in the lower abdominal area (T12-L1) rather than the upper abdomen has recently been introduced as an alternative procedure for laparoscopic cholecystectomy. Therefore, we investigated the time course of different components of pain and the analgesic effect of the bilateral ultrasound-guided split injection technique for rectus sheath block (sRSB) after RC in female patients.
We randomly assigned 40 patients to undergo ultrasound-guided sRSB (RSB group, n = 20) or to not undergo any block (control group, n = 20). Pain was subdivided into 3 components: superficial wound pain, deep abdominal pain, and referred shoulder pain, which were evaluated with a numeric rating scale (from 0 to 10) at baseline (time of awakening) and at 1, 6, 9, and 24 hours postoperatively. Consumption of fentanyl and general satisfaction were also evaluated 1 hour (before discharge from the postanesthesia care unit) and 24 hours postoperatively (end of study).
Superficial wound pain was predominant only at awakening, and after postoperative 1 hour in the control group. Bilateral ultrasound-guided sRSB significantly decreased superficial pain after RC (P < 0.01) and resulted in a better satisfaction score (P < 0.05) 1 hour after RC in the RSB group compared with the control group. The cumulative postoperative consumption of fentanyl at 6, 9, and 24 hours was not significantly different between groups.
After RC with lower abdominal ports, superficial wound pain predominates over deep intra-abdominal pain and shoulder pain only at the time of awakening. Afterwards, superficial and deep pain decreased to insignificant levels in 6 hours. Bilateral ultrasound-guided sRSB was effective only during the first hour. This limited benefit should be balanced against the time and risks entailed in performing RSB.</abstract><cop>United States</cop><pub>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>27495072</pmid><doi>10.1097/MD.0000000000004445</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Wolters Kluwer Open Health; IngentaConnect Free/Open Access Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Aged Anesthetics, Local - administration & dosage Cholecystectomy, Laparoscopic - adverse effects Cholecystectomy, Laparoscopic - methods Clinical Trial/Experimental Study Female Follow-Up Studies Humans Middle Aged Nerve Block - methods Pain Measurement Pain, Postoperative - prevention & control Prospective Studies Rectus Abdominis - drug effects Risk Assessment Robotic Surgical Procedures - adverse effects Robotic Surgical Procedures - methods Robotics Single-Blind Method Treatment Outcome Ultrasonography, Interventional - methods |
| title | Pain related to robotic cholecystectomy with lower abdominal ports: effect of the bilateral ultrasound-guided split injection technique of rectus sheath block in female patients: A prospective randomised trial |
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