Department of Surgery, University Medical City, King Saud University, Riyadh, Saudi Arabia.
Anesthesia Department, University Medical City, King Saud University, Riyadh, Saudi Arabia.
JSLS. 2022 Jul-Sep;26(3). doi: 10.4293/JSLS.2022.00049.
The increasing prevalence of obesity is a significant concern worldwide. Laparoscopic sleeve gastrectomy (LSG) is an effective and standard procedure for sustained weight loss. However, optimal pain control is essential for enhanced recovery after surgery. The aim of this randomized controlled study was to investigate the efficacy of a pre-incisional laparoscopic preperitoneal local anesthetic technique (PLPLAT) on recovery characteristics following LSG.
A total of 120 obese patients scheduled to undergo LSG were randomized into the PLPLAT or placebo group (n = 60 patients in both groups). All patients received conventional intravenous or other analgesics postoperatively, as required. The primary outcome was the postoperative pain score. The secondary outcomes included morphine consumption, other analgesics, length of stay in the postanesthesia care unit (PACU), hemodynamic changes, postoperative nausea and vomiting (PONV), early mobilization, and length of hospital stay.
Pain scores in the PACU and at 12 hours after surgery in the ward were significantly lower in the PLPLAT group than in the placebo group (P < 0.05). The morphine consumption was significantly less in PLPLAT group with mean dosage of 2.95 mg (± 0.39) compared to 6.0 mg (± 0.4) in placebo group. PONV, mean arterial pressure, and PACU stay were significantly higher in the placebo group than in the PLPLAT group (P < 0.05).
Intraoperative PLPLAT provide effective postoperative pain relief for patients undergoing LSG. The findings indicated the efficacy of PLPLAT in reducing postoperative pain, enhancing recovery, and facilitating early discharge.
肥胖症的患病率不断上升是全球范围内的一个重大关注点。腹腔镜袖状胃切除术（LSG）是一种有效的标准手术方法，可实现持续的体重减轻。然而，优化疼痛控制对于手术后的恢复至关重要。本随机对照研究旨在探讨切口前腹腔镜腹膜前局部麻醉技术（PLPLAT）对 LSG 术后恢复特征的疗效。
共 120 名计划接受 LSG 的肥胖患者被随机分为 PLPLAT 或安慰剂组（每组 60 例患者）。所有患者术后均根据需要接受常规静脉或其他镇痛药物。主要结局是术后疼痛评分。次要结局包括吗啡消耗量、其他镇痛药、麻醉后监护病房（PACU）停留时间、血流动力学变化、术后恶心和呕吐（PONV）、早期活动和住院时间。
PACU 中的疼痛评分和术后 12 小时病房中的疼痛评分在 PLPLAT 组明显低于安慰剂组（P < 0.05）。PLPLAT 组的吗啡消耗量明显低于安慰剂组，平均剂量为 2.95 ± 0.39mg，而安慰剂组为 6.0 ± 0.4mg。PONV、平均动脉压和 PACU 停留时间在安慰剂组明显高于 PLPLAT 组（P < 0.05）。
术中 PLPLAT 为接受 LSG 的患者提供了有效的术后疼痛缓解。研究结果表明 PLPLAT 可减少术后疼痛、促进恢复和促进早期出院。
