ArticleLangenbeck's archives of surgery2025
Influence of intercostal nerve block preemptive analgesia and incisional infiltration anesthesia on postoperative pain in patients undergoing laparoscopic cholecystectomy.
Article in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study is aiming at analyzing the effects of intercostal nerve block preemptive analgesia and incisional infiltration anesthesia on postoperative pain in patients undergoing laparoscopic cholecystectomy.
methodsNinety patients who underwent laparoscopic cholecystectomy were retrospectively selected. According to different anesthesia methods, they were allocated into an intervention group and a control group, with 45 patients in each. The control group received incisional infiltration anesthesia alone, while the intervention group received intercostal nerve block with preemptive anesthesia combined with incisional infiltration. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 4, 8, 12, and 24 h postoperatively at rest, and during mobilization at 8, 12, and 24 h. Postoperative analgesia conditions, as well as the operative time, length of hospital stay, time to first ambulation, and awakening time of the two groups, were compared. The incidence of adverse events was also compared.
resultsThe intervention group reported lower resting VAS scores at 4, 8, 12, and 24 h and lower movement-related VAS scores at 8, 12, and 24 h (all P < 0.05). The number of cases with VAS ≥ 4 at 4 h, 8 h, 12 h, and 24 h postoperatively in the control group was higher than that in the intervention group (P = 0.020, 0.033, 0.034, 0.019). Moreover, the proportion of patients who did not receive additional tramadol in the intervention group was higher at 4 h, 8 h, 12 h, and 24 h postoperatively [2/13 (15.38%) vs. 2/24 (8.33%); 5/16 (31.25%) vs. 3/28 (10.71%); 7/13 (53.85%) vs. 4/26 (15.38%); 4/10 (40.00%) vs. 3/22 (13.64%)]. There was no significant difference in the operative time between the two groups (P = 0.065). The length of hospital stay, time to first ambulation, and awakening time in the intervention group were all shorter than those in the control group (P < 0.05). The incidence of adverse events did not differ significantly between groups (8.89% vs. 13.33%, P = 0.739).
conclusionPreemptive analgesia with intercostal nerve block & incisional infiltration anesthesia offers effective pain control in laparoscopic cholecystectomy, reducing the use of postoperative drugs, with a favorable safety profile.
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