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Erschienen in: Surgical Endoscopy 10/2005

01.10.2005 | Original article

A procedure-specific systematic review and consensus recommendations for postoperative analgesia following laparoscopic cholecystectomy

verfasst von: H. Kehlet, A. W. Gray, F. Bonnet, F. Camu, H. B. J. Fischer, R. F. McCloy, E. A. M. Neugebauer, M. M. Puig, N. Rawal, C. J. P. Simanski

Erschienen in: Surgical Endoscopy | Ausgabe 10/2005

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Abstract

Background:

Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain. However, a systematic review of postoperative pain management in this procedure has not been conducted.

Methods:

A systematic review was conducted according to the guidelines of the Cochrane Collaboration. Randomized studies examining the effect of medical or surgical interventions on linear pain scores in patients undergoing laparoscopic cholecystectomy were included. Qualitative and quantitative analyses were performed. Recommendations for patient care were derived from review of these data, evidence from other relevant procedures, and clinical practice observations collated by the Delphi method among the authors.

Results:

Sixty-nine randomized trials were included and 77 reports were excluded. Recommendations are provided for preoperative analgesia, anesthetic and operative techniques, and intraoperative and postoperative analgesia.

Conclusions:

A step-up approach to the management of postoperative pain following laparoscopic cholecystectomy is recommended. This approach has been designed to provide adequate analgesia while minimizing exposure to adverse events.
Literatur
1.
Zurück zum Zitat Clarke M, Oxman AD (eds) (2001) Cochrane Reviewers Handbook 4.1.4 [updated October 2001]. In: The Cochrane Library, Issue 4. Oxford: Update Software Clarke M, Oxman AD (eds) (2001) Cochrane Reviewers Handbook 4.1.4 [updated October 2001]. In: The Cochrane Library, Issue 4. Oxford: Update Software
2.
Zurück zum Zitat Aitola P, Airo I, Kaukinen S, Ylitalo P (1998) Comparison of N2O and CO2 pneumoperitoneums during laparoscopic cholecystectomy with special reference to postoperative pain. Surg Laparosc Endosc 8(2): 140–144CrossRefPubMed Aitola P, Airo I, Kaukinen S, Ylitalo P (1998) Comparison of N2O and CO2 pneumoperitoneums during laparoscopic cholecystectomy with special reference to postoperative pain. Surg Laparosc Endosc 8(2): 140–144CrossRefPubMed
3.
Zurück zum Zitat Alexander DJ, Ngoi SS, Lee L, So J, Mak K, Chan S, Goh PM (1996) Randomized trial of peri-portal peritoneal bupivacaine for pain relief after laparoscopic cholecystectomy. Br J Surg 83: 1223–1225CrossRefPubMed Alexander DJ, Ngoi SS, Lee L, So J, Mak K, Chan S, Goh PM (1996) Randomized trial of peri-portal peritoneal bupivacaine for pain relief after laparoscopic cholecystectomy. Br J Surg 83: 1223–1225CrossRefPubMed
4.
Zurück zum Zitat Alponat A, Cubukcu A, Gonullu N, Canturk Z, Ozbay O (2002) Is minisite cholecystectomy less traumatic? Prospective randomized study comparing minisite and conventional laparoscopic cholecystectomies. World J Surg 26(12): 1437–1440CrossRefPubMed Alponat A, Cubukcu A, Gonullu N, Canturk Z, Ozbay O (2002) Is minisite cholecystectomy less traumatic? Prospective randomized study comparing minisite and conventional laparoscopic cholecystectomies. World J Surg 26(12): 1437–1440CrossRefPubMed
5.
Zurück zum Zitat Apfelbaum JL, Chen C, Mehta SS, Gan TJ (2003) Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 97(2): 534–540CrossRefPubMed Apfelbaum JL, Chen C, Mehta SS, Gan TJ (2003) Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 97(2): 534–540CrossRefPubMed
6.
Zurück zum Zitat Barczynski M, Herman RM (2003) A prospective randomized trial on comparison of low-pressure (LP) and standard-pressure (SP) pneumoperitoneum for laparoscopic cholecystectomy. Surg Endosc 17(4): 533–538CrossRefPubMed Barczynski M, Herman RM (2003) A prospective randomized trial on comparison of low-pressure (LP) and standard-pressure (SP) pneumoperitoneum for laparoscopic cholecystectomy. Surg Endosc 17(4): 533–538CrossRefPubMed
7.
Zurück zum Zitat Barden J, Edwards JE, McQuay HJ, Andrew Moore R (2004) Pain and analgesic response after third molar extraction and other postsurgical pain. Pain 107(1–2): 86–90CrossRefPubMed Barden J, Edwards JE, McQuay HJ, Andrew Moore R (2004) Pain and analgesic response after third molar extraction and other postsurgical pain. Pain 107(1–2): 86–90CrossRefPubMed
8.
Zurück zum Zitat Bardiau FM, Taviaux NF, Albert A, Boogaerts JG, Stadler M (2003) An intervention study to enhance postoperative pain management. Anesth Analg 96(1): 179–185CrossRefPubMed Bardiau FM, Taviaux NF, Albert A, Boogaerts JG, Stadler M (2003) An intervention study to enhance postoperative pain management. Anesth Analg 96(1): 179–185CrossRefPubMed
9.
Zurück zum Zitat Berberoglu M, Dilek ON, Ercan F, Kati I, Ozmen M (1998) The effect of carbon dioxide insufflation rate on the postlaparoscopic shoulder pain. J Laparoendosc Adv Surg Tech A 8(5): 273–277PubMed Berberoglu M, Dilek ON, Ercan F, Kati I, Ozmen M (1998) The effect of carbon dioxide insufflation rate on the postlaparoscopic shoulder pain. J Laparoendosc Adv Surg Tech A 8(5): 273–277PubMed
10.
Zurück zum Zitat Bhoyrul S, Payne J, Steffes B, Swanstrom L, Way LW (2000) A randomized prospective study of radially expanding trocars in laparoscopic surgery. J Gastrointest Surg 4: 392–397CrossRefPubMed Bhoyrul S, Payne J, Steffes B, Swanstrom L, Way LW (2000) A randomized prospective study of radially expanding trocars in laparoscopic surgery. J Gastrointest Surg 4: 392–397CrossRefPubMed
11.
Zurück zum Zitat Bisgaard T, Kehlet H, Rosenberg J (2001) Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg 167(2): 84–96CrossRefPubMed Bisgaard T, Kehlet H, Rosenberg J (2001) Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg 167(2): 84–96CrossRefPubMed
12.
Zurück zum Zitat Bisgaard T, Klarskov B, Kehlet H, Rosenberg J (2002) Recovery after uncomplicated laparoscopic cholecystectomy. Surgery 132(5): 817–825CrossRefPubMed Bisgaard T, Klarskov B, Kehlet H, Rosenberg J (2002) Recovery after uncomplicated laparoscopic cholecystectomy. Surgery 132(5): 817–825CrossRefPubMed
13.
Zurück zum Zitat Bisgaard T, Klarskov B, Kehlet H, Rosenberg J (2003) Preoperative dexamethasone improves surgical outcome after laparoscopic cholecystectomy: a randomized double-blind placebo- controlled trial. Ann Surg 238(5): 651–660CrossRefPubMed Bisgaard T, Klarskov B, Kehlet H, Rosenberg J (2003) Preoperative dexamethasone improves surgical outcome after laparoscopic cholecystectomy: a randomized double-blind placebo- controlled trial. Ann Surg 238(5): 651–660CrossRefPubMed
14.
Zurück zum Zitat Bisgaard T, Klarskov B, Kristiansen VB, Callesen T, Schulze S, Kehlet H, Rosenberg J (1999) Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study. Anesth Analg 89: 1017–1024CrossRefPubMed Bisgaard T, Klarskov B, Kristiansen VB, Callesen T, Schulze S, Kehlet H, Rosenberg J (1999) Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study. Anesth Analg 89: 1017–1024CrossRefPubMed
15.
Zurück zum Zitat Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J (2000) Pain after microlaparoscopic cholecystectomy. A randomized double-blind controlled study. Surg Endosc 14: 340–344CrossRefPubMed Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J (2000) Pain after microlaparoscopic cholecystectomy. A randomized double-blind controlled study. Surg Endosc 14: 340–344CrossRefPubMed
16.
Zurück zum Zitat Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J (2002) Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial. Surg Endosc 16: 458–464CrossRefPubMed Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J (2002) Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial. Surg Endosc 16: 458–464CrossRefPubMed
17.
Zurück zum Zitat Breitfeld C, Peters J, Vockel T, Lorenz C, Eikermann M (2003) Emetic effects of morphine and piritramide. Br J Anaesth 91(2): 218–223CrossRefPubMed Breitfeld C, Peters J, Vockel T, Lorenz C, Eikermann M (2003) Emetic effects of morphine and piritramide. Br J Anaesth 91(2): 218–223CrossRefPubMed
18.
Zurück zum Zitat Bresadola F, Pasqualucci A, Donini A, Chiarandini P, Anania G, Terrosu G, Sistu MA, Pa-setto A (1999) Elective transumbilical compared with standard laparoscopic cholecystectomy. Eur JSurg 165(1): 29–34 Bresadola F, Pasqualucci A, Donini A, Chiarandini P, Anania G, Terrosu G, Sistu MA, Pa-setto A (1999) Elective transumbilical compared with standard laparoscopic cholecystectomy. Eur JSurg 165(1): 29–34
19.
Zurück zum Zitat Brooker CD, Sutherland J, Cousins MJ (1998) Propofol maintenance to reduce postoperative emesis in thyroidectomy patients: a group sequential comparison with isoflurane/nitrous oxide. Anaesth Intensive Care 26(6): 625–629PubMed Brooker CD, Sutherland J, Cousins MJ (1998) Propofol maintenance to reduce postoperative emesis in thyroidectomy patients: a group sequential comparison with isoflurane/nitrous oxide. Anaesth Intensive Care 26(6): 625–629PubMed
20.
Zurück zum Zitat Busley R, Blobner M, Esselborn J-, Feussner H, Kochs E (1999) Intraperitoneal local anaesthetics via subphrenic catheter following laparoscopic cholecystectomy: pain relief and pulmonary function. Min Invas Ther and Allied Technol 8(4): 219–225 Busley R, Blobner M, Esselborn J-, Feussner H, Kochs E (1999) Intraperitoneal local anaesthetics via subphrenic catheter following laparoscopic cholecystectomy: pain relief and pulmonary function. Min Invas Ther and Allied Technol 8(4): 219–225
21.
Zurück zum Zitat Campbell L, Plummer J, Owen H, Czuchwicki A, Ilsley A (2000) Effect of short-term ketorolac infusion on recovery following laparoscopic day surgery. Anaesth Intensive Care 28: 654–659PubMed Campbell L, Plummer J, Owen H, Czuchwicki A, Ilsley A (2000) Effect of short-term ketorolac infusion on recovery following laparoscopic day surgery. Anaesth Intensive Care 28: 654–659PubMed
22.
Zurück zum Zitat Cete MH, Ozmen MM, Hengirmen S, Kadioglu Y (1996) The role of bupivacaine in decreasing postoperative pain and pulmonary complications. Gazi Medical Journal 7: 93–96 Cete MH, Ozmen MM, Hengirmen S, Kadioglu Y (1996) The role of bupivacaine in decreasing postoperative pain and pulmonary complications. Gazi Medical Journal 7: 93–96
23.
Zurück zum Zitat Chanvej L, Kijsirikul S, Thongsuksai P, Naheem L (2001) Post-operative nausea and vomiting in out-patient gynecologic laparoscopy: a comparison of thiopental-nitrous oxide, propofol-nitrous oxide and total intravenous anesthesia using propofol. J Med Assoc Thai 84(5): 697–704PubMed Chanvej L, Kijsirikul S, Thongsuksai P, Naheem L (2001) Post-operative nausea and vomiting in out-patient gynecologic laparoscopy: a comparison of thiopental-nitrous oxide, propofol-nitrous oxide and total intravenous anesthesia using propofol. J Med Assoc Thai 84(5): 697–704PubMed
24.
Zurück zum Zitat Cheah WK, Lenzi JE, So JBY, Kum CK, Goh PMY (2001) Randomized trial of neddlescopic versus laparoscopic cholecystectomy. Br J Surg 88: 45–47CrossRefPubMed Cheah WK, Lenzi JE, So JBY, Kum CK, Goh PMY (2001) Randomized trial of neddlescopic versus laparoscopic cholecystectomy. Br J Surg 88: 45–47CrossRefPubMed
25.
Zurück zum Zitat Chundrigar T, Hedges AR, Morris R, Stamatakis JD (1993) Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy. Ann R Coll Surg Engl 75: 437–439PubMed Chundrigar T, Hedges AR, Morris R, Stamatakis JD (1993) Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy. Ann R Coll Surg Engl 75: 437–439PubMed
26.
Zurück zum Zitat Coloma M, White PF, Markowitz SD, Whitten CW, Macaluso AR, Berrisford SB, Thornton KC (2002) Dexamethasone in combination with dolasetron for prophylaxis in the ambulatory setting: effect on outcome after laparoscopic cholecystectomy. Anesthesiology 96(6): 1346–1350CrossRefPubMed Coloma M, White PF, Markowitz SD, Whitten CW, Macaluso AR, Berrisford SB, Thornton KC (2002) Dexamethasone in combination with dolasetron for prophylaxis in the ambulatory setting: effect on outcome after laparoscopic cholecystectomy. Anesthesiology 96(6): 1346–1350CrossRefPubMed
27.
Zurück zum Zitat Cunniffe MG, McAnena OJ, Dar MA, Calleary J, Flynn N (1998) A prospective randomized trial of intraoperative bupivacaine irrigation for management of shoulder-tip pain following laparo-scopy. Am J Surg 176: 258–261CrossRefPubMed Cunniffe MG, McAnena OJ, Dar MA, Calleary J, Flynn N (1998) A prospective randomized trial of intraoperative bupivacaine irrigation for management of shoulder-tip pain following laparo-scopy. Am J Surg 176: 258–261CrossRefPubMed
28.
Zurück zum Zitat Dalkey N, Helmer O (1963) An experimental application of the Delphi Method to the use of experts. Management Saence 9(3): 458 Dalkey N, Helmer O (1963) An experimental application of the Delphi Method to the use of experts. Management Saence 9(3): 458
29.
Zurück zum Zitat Dath D, Park AE (1999) Randomised controlled trial of bupivacaine injection to decrease pain after laparoscopic cholecystectomy. Can J Surg 42(4): 284–288PubMed Dath D, Park AE (1999) Randomised controlled trial of bupivacaine injection to decrease pain after laparoscopic cholecystectomy. Can J Surg 42(4): 284–288PubMed
30.
Zurück zum Zitat De Deyne C, Struys M, Heylen R, De Jongh R, Van der Laenen M, Buyse L, Deghislage J, Rolly G (2000) Influence of intravenous clonidine pretreatment on anesthetic requirements during bispectral EEG-guided sevoflurane anesthesia. J Clin Anesth 12(1): 52–57CrossRefPubMed De Deyne C, Struys M, Heylen R, De Jongh R, Van der Laenen M, Buyse L, Deghislage J, Rolly G (2000) Influence of intravenous clonidine pretreatment on anesthetic requirements during bispectral EEG-guided sevoflurane anesthesia. J Clin Anesth 12(1): 52–57CrossRefPubMed
31.
Zurück zum Zitat Elfberg B-A, Sjovall-Mjoberg S (2000) Intraperitoneal bupivacaine does not effectively reduce pain after laparoscopic cholecystectomy: a randomized, plaebo-controlled and double-blind study. Surg Laparosc Endosc Percutan Tech 10(6): 357–359CrossRefPubMed Elfberg B-A, Sjovall-Mjoberg S (2000) Intraperitoneal bupivacaine does not effectively reduce pain after laparoscopic cholecystectomy: a randomized, plaebo-controlled and double-blind study. Surg Laparosc Endosc Percutan Tech 10(6): 357–359CrossRefPubMed
32.
Zurück zum Zitat Elhakim M, Amine H, Kamel S, Saad F (2000) Effects of intraperitoneal lidocaine combined with intravenous or intraperitoneal tenoxicam on pain relief and bowel recovery after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 44: 929–933CrossRefPubMed Elhakim M, Amine H, Kamel S, Saad F (2000) Effects of intraperitoneal lidocaine combined with intravenous or intraperitoneal tenoxicam on pain relief and bowel recovery after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 44: 929–933CrossRefPubMed
33.
Zurück zum Zitat Elhakim M, Ghalaab M, Soliman M (1995) The effects of ondansetron and balanced analgesia on posetoperative nausea and vomiting in laparoscopic surgery. Acta Anaesth/Italica 46: 23–28 Elhakim M, Ghalaab M, Soliman M (1995) The effects of ondansetron and balanced analgesia on posetoperative nausea and vomiting in laparoscopic surgery. Acta Anaesth/Italica 46: 23–28
34.
Zurück zum Zitat Elhakim M, Nafie M, Mahmoud K, Atef A (2002) Dexamethasone 8 mg in combination with ondansetron 4 mg appears to be the optimal dose for the prevention of nausea and vomiting after laparoscopic cholecystectomy. Can J Anaesth 49(9): 922–926PubMed Elhakim M, Nafie M, Mahmoud K, Atef A (2002) Dexamethasone 8 mg in combination with ondansetron 4 mg appears to be the optimal dose for the prevention of nausea and vomiting after laparoscopic cholecystectomy. Can J Anaesth 49(9): 922–926PubMed
35.
Zurück zum Zitat Flisberg P, Rudin A, Linner R, Lundberg CJ (2003) Pain relief and safety after major surgery. A prospective study of epidural and intravenous analgesia in 2696 patients. Acta Anaesthesiol Scand 47(4): 457–465CrossRefPubMed Flisberg P, Rudin A, Linner R, Lundberg CJ (2003) Pain relief and safety after major surgery. A prospective study of epidural and intravenous analgesia in 2696 patients. Acta Anaesthesiol Scand 47(4): 457–465CrossRefPubMed
36.
Zurück zum Zitat Forse A, EI-Beheiry H, Butler PO, Pace RF (1996) Indomethacin and ketorolac given preop-eratively are equally effective in reducing early postoperative pain after laparoscopic cholecystectomy. Can J Anaesth 39: 26–30 Forse A, EI-Beheiry H, Butler PO, Pace RF (1996) Indomethacin and ketorolac given preop-eratively are equally effective in reducing early postoperative pain after laparoscopic cholecystectomy. Can J Anaesth 39: 26–30
37.
Zurück zum Zitat Frank ED, McKay W, Rocco A, Gallo JP (1990) Interpleural bupivacaine for postoperative analgesia following cholecystectomy: a randomized prospective study. Reg Anesth 15(1): 26–30PubMed Frank ED, McKay W, Rocco A, Gallo JP (1990) Interpleural bupivacaine for postoperative analgesia following cholecystectomy: a randomized prospective study. Reg Anesth 15(1): 26–30PubMed
38.
Zurück zum Zitat Fredman B, Olsfanger D, Jedeikin R (1995) A comparative study of ketorolac and diclofenac on post- laparoscopic cholecystectomy pain. Eur J Anaesthesiol 12: 501–504PubMed Fredman B, Olsfanger D, Jedeikin R (1995) A comparative study of ketorolac and diclofenac on post- laparoscopic cholecystectomy pain. Eur J Anaesthesiol 12: 501–504PubMed
39.
Zurück zum Zitat Frenette L, Boudreault D, Guay J (1991) Interpleural analgesia improves pulmonary function after cholecystectomy. Can J Anaesth 38(1): 71–74PubMed Frenette L, Boudreault D, Guay J (1991) Interpleural analgesia improves pulmonary function after cholecystectomy. Can J Anaesth 38(1): 71–74PubMed
40.
Zurück zum Zitat Fujii Y, Saitoh Y, Tanaka H, Toyooka H (2000) Graniseteron/dexamethasone combination for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Eur J Anaesthesiol 17: 64–68CrossRefPubMed Fujii Y, Saitoh Y, Tanaka H, Toyooka H (2000) Graniseteron/dexamethasone combination for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Eur J Anaesthesiol 17: 64–68CrossRefPubMed
41.
Zurück zum Zitat Fujii Y, Toyooka H, Tanaka H (1998) Efficacy of thoracic epidural analgesia following laparoscopic cholecystectomy. Eur J Anaesthesiol 15: 342–344CrossRefPubMed Fujii Y, Toyooka H, Tanaka H (1998) Efficacy of thoracic epidural analgesia following laparoscopic cholecystectomy. Eur J Anaesthesiol 15: 342–344CrossRefPubMed
42.
Zurück zum Zitat Gallagher EJ, Liebman M, Bijur PE (2001) Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med 38(6): 633–638CrossRefPubMed Gallagher EJ, Liebman M, Bijur PE (2001) Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med 38(6): 633–638CrossRefPubMed
43.
Zurück zum Zitat Gan TJ, Joshi GP, Viscusi E, Cheung RY, Dodge W, Fort JD, Chen C (2004) Preoperative parenteral parecoxib and follow-up oral valdecoxib reduces length of stay and improves quality of patient recovery after laparoscopic cholecystectomy surgery. Anesth Analg 98: 1665–1673CrossRefPubMed Gan TJ, Joshi GP, Viscusi E, Cheung RY, Dodge W, Fort JD, Chen C (2004) Preoperative parenteral parecoxib and follow-up oral valdecoxib reduces length of stay and improves quality of patient recovery after laparoscopic cholecystectomy surgery. Anesth Analg 98: 1665–1673CrossRefPubMed
44.
Zurück zum Zitat Gharaibeh KIA, Al-Jaberi TMQ (2000) Bupivacaine instillation into gallbladder bed after laparoscopic cholecystectomy: does it decrease shoulder pain? J Laparoendosc Adv Surg Tech A 10(3): 137–141PubMed Gharaibeh KIA, Al-Jaberi TMQ (2000) Bupivacaine instillation into gallbladder bed after laparoscopic cholecystectomy: does it decrease shoulder pain? J Laparoendosc Adv Surg Tech A 10(3): 137–141PubMed
45.
Zurück zum Zitat Gillberg LE, Harsten AS, Stahl LB (1993) Preoperative diclofenac sodium reduces post-laparoscopy pain. Can J Anaesth 40(5): 406–408PubMed Gillberg LE, Harsten AS, Stahl LB (1993) Preoperative diclofenac sodium reduces post-laparoscopy pain. Can J Anaesth 40(5): 406–408PubMed
46.
Zurück zum Zitat Golder M, Rhodes M (1998) Prospective randomized trial of 5- and 10-mm epigastric orts in laparoscopic cholecystectomy. Brit. J. Surg 85: 1066–1067CrossRefPubMed Golder M, Rhodes M (1998) Prospective randomized trial of 5- and 10-mm epigastric orts in laparoscopic cholecystectomy. Brit. J. Surg 85: 1066–1067CrossRefPubMed
47.
Zurück zum Zitat Green CR, Wheeler JR (2003) Physician variability in the management of acute postoperative and cancer pain: a quantitative analysis of the Michigan experience. Pain Med 4(1): 8–20CrossRefPubMed Green CR, Wheeler JR (2003) Physician variability in the management of acute postoperative and cancer pain: a quantitative analysis of the Michigan experience. Pain Med 4(1): 8–20CrossRefPubMed
48.
Zurück zum Zitat Guillou N, Tanguy M, Seguin P, Branger B, Campion JP, Malledant Y (2003) The effects of small-dose ketamine on morphine consumption in surgical intensive care unit patients after major abdominal surgery. Anesth Analg 97(3): 843–847CrossRefPubMed Guillou N, Tanguy M, Seguin P, Branger B, Campion JP, Malledant Y (2003) The effects of small-dose ketamine on morphine consumption in surgical intensive care unit patients after major abdominal surgery. Anesth Analg 97(3): 843–847CrossRefPubMed
49.
Zurück zum Zitat Gupta A, Thorn SE, Axelsson K, Larsson LG, Agren G, Holmstrom B, Rawal N (2002) Postoperative pain relief using intermittent injections of 0.5% ropivacaine through a catheter after laparoscopic cholecystectomy. Anesth Analg 95(2): 450–456, table of contentsCrossRefPubMed Gupta A, Thorn SE, Axelsson K, Larsson LG, Agren G, Holmstrom B, Rawal N (2002) Postoperative pain relief using intermittent injections of 0.5% ropivacaine through a catheter after laparoscopic cholecystectomy. Anesth Analg 95(2): 450–456, table of contentsCrossRefPubMed
50.
Zurück zum Zitat Gurmarnick S, Poreda M, Reid GM, Frasca JT, Paul-Blanc R (1996) A combination of low dose spinal and general anaesthesia for laparoscopic cholecystectomy. Can J Anaesth 43: 95PubMed Gurmarnick S, Poreda M, Reid GM, Frasca JT, Paul-Blanc R (1996) A combination of low dose spinal and general anaesthesia for laparoscopic cholecystectomy. Can J Anaesth 43: 95PubMed
51.
Zurück zum Zitat Hakanson E, Bengtsson M, Rutberg H, Ulrick AM (1989) Epidural morphine by the thoracic or lumbar routes in cholecystectomy. Effect on postoperative pain and respiratory variables. Anaesth Intensive Care 17: 166–169PubMed Hakanson E, Bengtsson M, Rutberg H, Ulrick AM (1989) Epidural morphine by the thoracic or lumbar routes in cholecystectomy. Effect on postoperative pain and respiratory variables. Anaesth Intensive Care 17: 166–169PubMed
52.
Zurück zum Zitat Hasaniya NW, Zayed FF, Faiz H, Severino R (2001) Preinsertion local anesthesia at the trocar site improves perioperative pain and decreases costs of laparoscopic cholecystectomyq. Surg Endosc 15: 962–964CrossRefPubMed Hasaniya NW, Zayed FF, Faiz H, Severino R (2001) Preinsertion local anesthesia at the trocar site improves perioperative pain and decreases costs of laparoscopic cholecystectomyq. Surg Endosc 15: 962–964CrossRefPubMed
53.
Zurück zum Zitat Hawasli A, Brown E (1994) The effect of drains in laparoscopic cholecystectomy. J Laparoendosc Surg 4(6): 393–398PubMed Hawasli A, Brown E (1994) The effect of drains in laparoscopic cholecystectomy. J Laparoendosc Surg 4(6): 393–398PubMed
54.
Zurück zum Zitat Holte K, Kehlet H (2002) Perioperative single-dose glucocorticoid administration: patho-physiologic effects and clinical implications. J Am Coll Surg 195(5): 694–712CrossRefPubMed Holte K, Kehlet H (2002) Perioperative single-dose glucocorticoid administration: patho-physiologic effects and clinical implications. J Am Coll Surg 195(5): 694–712CrossRefPubMed
55.
Zurück zum Zitat Hong JY, Lee IH (2003) Suprascapular nerve block or a piroxicam patch for shoulder tip pain after day case laparoscopic surgery. Eur J Anaesthesiol 20(3): 234–238CrossRefPubMed Hong JY, Lee IH (2003) Suprascapular nerve block or a piroxicam patch for shoulder tip pain after day case laparoscopic surgery. Eur J Anaesthesiol 20(3): 234–238CrossRefPubMed
56.
Zurück zum Zitat Hong SJ, Cho EJ, Lee JY, Kim WW, Kim EK (2003) The physiologic response to laparoscopic cholecystectomy: CO2 pneumoperitoneum vs wall lift. Can J Anaesth 50(2): 200–201PubMed Hong SJ, Cho EJ, Lee JY, Kim WW, Kim EK (2003) The physiologic response to laparoscopic cholecystectomy: CO2 pneumoperitoneum vs wall lift. Can J Anaesth 50(2): 200–201PubMed
57.
Zurück zum Zitat Huang FY, Fan SZ, Wang MS, Chen TL, Sun WZ, Lin SY (1990) Comparison of continuous epidural infusion of fentanyl and fentanyl-bupivacaine for post cholecystectomy pain control. Ma Zui Xue Za Zhi 28: 9–13PubMed Huang FY, Fan SZ, Wang MS, Chen TL, Sun WZ, Lin SY (1990) Comparison of continuous epidural infusion of fentanyl and fentanyl-bupivacaine for post cholecystectomy pain control. Ma Zui Xue Za Zhi 28: 9–13PubMed
58.
Zurück zum Zitat Hyllested M, Jones S, Pedersen JL, Kehlet H (2002) Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth 88(2): 199–214CrossRefPubMed Hyllested M, Jones S, Pedersen JL, Kehlet H (2002) Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth 88(2): 199–214CrossRefPubMed
59.
Zurück zum Zitat Jadad AR, Moore A, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17: 1–12CrossRefPubMed Jadad AR, Moore A, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17: 1–12CrossRefPubMed
60.
Zurück zum Zitat Jelicic M, Bonke B, Millar K (1993) Effect of different therapeutic suggestions presented during anaesthesia on post-operative course. Eur J Anaesthesiol 10: 343–347PubMed Jelicic M, Bonke B, Millar K (1993) Effect of different therapeutic suggestions presented during anaesthesia on post-operative course. Eur J Anaesthesiol 10: 343–347PubMed
61.
Zurück zum Zitat Jiranantarat V, Rushatamukayanunt W, Lert-akyamanee N, Sirijearanai R, Piromrat I, Su-wannanonda P, Muangkasem J (2002) Analgesic effect of intraperitoneal instillation of bupivacaine for postoperative laparoscopic cholecystectomy. J Med Assoc Thai 85(Suppl 3): S897–903PubMed Jiranantarat V, Rushatamukayanunt W, Lert-akyamanee N, Sirijearanai R, Piromrat I, Su-wannanonda P, Muangkasem J (2002) Analgesic effect of intraperitoneal instillation of bupivacaine for postoperative laparoscopic cholecystectomy. J Med Assoc Thai 85(Suppl 3): S897–903PubMed
62.
Zurück zum Zitat Jorgensen JO, Gillies RB, Hunt DR, Caplehorn JRM, Lumley T (1995) A simple and effective way to reduce postoperative pain after laparoscopic cholecydtectomy. Aust NZ. J Surg 65: 466–469 Jorgensen JO, Gillies RB, Hunt DR, Caplehorn JRM, Lumley T (1995) A simple and effective way to reduce postoperative pain after laparoscopic cholecydtectomy. Aust NZ. J Surg 65: 466–469
63.
Zurück zum Zitat Joris J, Thiry E, Paris P, Weerts J, Lamy M (1995) Pain after laparoscopic cholecystectomy: Characteristics and effect of intraperitoneal bupivacaine. Anesth Analg 81: 379–384CrossRefPubMed Joris J, Thiry E, Paris P, Weerts J, Lamy M (1995) Pain after laparoscopic cholecystectomy: Characteristics and effect of intraperitoneal bupivacaine. Anesth Analg 81: 379–384CrossRefPubMed
64.
Zurück zum Zitat Joshi GP, Viscusi ER, Can TJ, Minkowitz H, Cippolle M, Schuller R, Cheung RY, Fort JG (2004) Effective treatment of laparoscopic cholecystectomy pain with intravenous followed by oral COX-2 specific inhibitor. Anesth Analg 98(2): 336–342, table of contentsCrossRefPubMed Joshi GP, Viscusi ER, Can TJ, Minkowitz H, Cippolle M, Schuller R, Cheung RY, Fort JG (2004) Effective treatment of laparoscopic cholecystectomy pain with intravenous followed by oral COX-2 specific inhibitor. Anesth Analg 98(2): 336–342, table of contentsCrossRefPubMed
65.
Zurück zum Zitat Kehlet H, Bonnet F, Camu F, Fischer HBJ, McCloy RF, Neugebauer EAM, Puig MM, Rawal N, Simanski CJP (2003) PROSPECT guidelines for the management of pain following laparoscopic cholecystectomy. www.postoppain.org Kehlet H, Bonnet F, Camu F, Fischer HBJ, McCloy RF, Neugebauer EAM, Puig MM, Rawal N, Simanski CJP (2003) PROSPECT guidelines for the management of pain following laparoscopic cholecystectomy. www.postoppain.org
66.
Zurück zum Zitat Kehlet H, Dahl JB (2003) Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 362(9399): 1921–1928CrossRefPubMed Kehlet H, Dahl JB (2003) Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 362(9399): 1921–1928CrossRefPubMed
67.
Zurück zum Zitat Cheung LY, Harken AH, Holcroft JW, Meakins JL, Sopor NJ (eds) (2002) Fast-track surgery. In: American College of Surgeons ACS Surgery: Principles and practice. New York: WebMD, pp. 1–10MathSciNet Cheung LY, Harken AH, Holcroft JW, Meakins JL, Sopor NJ (eds) (2002) Fast-track surgery. In: American College of Surgeons ACS Surgery: Principles and practice. New York: WebMD, pp. 1–10MathSciNet
68.
Zurück zum Zitat Kehlet H, Wilmore DW (2002) Multimodal strategies to improve surgical outcome. Am J Surg 183(6): 630–641CrossRefPubMed Kehlet H, Wilmore DW (2002) Multimodal strategies to improve surgical outcome. Am J Surg 183(6): 630–641CrossRefPubMed
69.
Zurück zum Zitat Kenady DE, Wilson JF, Schwartz RW, Bannon CL, Wermwling D (1992) A randomized comparison of patient-controlled versus standard analgesic requirements in patients undergoing cholecystectomy. Gynecol Obstet 174: 216–220 Kenady DE, Wilson JF, Schwartz RW, Bannon CL, Wermwling D (1992) A randomized comparison of patient-controlled versus standard analgesic requirements in patients undergoing cholecystectomy. Gynecol Obstet 174: 216–220
70.
Zurück zum Zitat Khan FA, Hameedullah (2002) Comparison of fentanyl and nalbuphine in total intravenous anaesthesia (TIVA). J Pak Med Assoc 52(10): 459–465PubMed Khan FA, Hameedullah (2002) Comparison of fentanyl and nalbuphine in total intravenous anaesthesia (TIVA). J Pak Med Assoc 52(10): 459–465PubMed
71.
Zurück zum Zitat Khan FA, Zaidi A, Kamal RS (1997) Comparison of nalbuphine and buprenorphine in total intravenous anaesthesia. Anaesthesia 52: 1095–1101CrossRefPubMed Khan FA, Zaidi A, Kamal RS (1997) Comparison of nalbuphine and buprenorphine in total intravenous anaesthesia. Anaesthesia 52: 1095–1101CrossRefPubMed
72.
Zurück zum Zitat Koivuranta MK, Laara E, Ryhanen PT (1996) Antiemetic efficacy of prophylactic ondansetron in laparoscopic cholecystectomy. Anaesthesia 51: 52–55PubMed Koivuranta MK, Laara E, Ryhanen PT (1996) Antiemetic efficacy of prophylactic ondansetron in laparoscopic cholecystectomy. Anaesthesia 51: 52–55PubMed
73.
Zurück zum Zitat Koivusalo A-M, Kellokumpu I, Lindgren L (1996) Gasless laparoscopic cholecystectomy: comparison of pastoperative recovery with conventional technique. Br J Anaesth 77: 576–580PubMed Koivusalo A-M, Kellokumpu I, Lindgren L (1996) Gasless laparoscopic cholecystectomy: comparison of pastoperative recovery with conventional technique. Br J Anaesth 77: 576–580PubMed
74.
Zurück zum Zitat Koivusalo A-M, Lindgren L (2000) Effects of carbondioxide pneumoperitoneum for laparoscopic cholecystectomy. Acta Anaesthesiol Scand 44: 834–841CrossRefPubMed Koivusalo A-M, Lindgren L (2000) Effects of carbondioxide pneumoperitoneum for laparoscopic cholecystectomy. Acta Anaesthesiol Scand 44: 834–841CrossRefPubMed
75.
Zurück zum Zitat Labaille T, Mazoit JX, Paqueron X, Franco D, Benhamou D (2002) The clinical efficacy and pharmacokinetics of intraperitoneal ropivacaine for laparoscopic cholecystectomy. Anesth Analg 94: 100–105CrossRefPubMed Labaille T, Mazoit JX, Paqueron X, Franco D, Benhamou D (2002) The clinical efficacy and pharmacokinetics of intraperitoneal ropivacaine for laparoscopic cholecystectomy. Anesth Analg 94: 100–105CrossRefPubMed
76.
Zurück zum Zitat L’Abbé KA, Detsky AS, O’Rourke K (1987) Meta-analysis in clinical research. Ann Intern Med 107:224–233PubMed L’Abbé KA, Detsky AS, O’Rourke K (1987) Meta-analysis in clinical research. Ann Intern Med 107:224–233PubMed
77.
Zurück zum Zitat Lam TYD, Lee SW, So HS, Kwok SPY (2000) Radically expanding trocar: a less painful alternative for laparoscopc surgery. J Laparoendosc Adv Surg Tech A 10(5): 269–273PubMed Lam TYD, Lee SW, So HS, Kwok SPY (2000) Radically expanding trocar: a less painful alternative for laparoscopc surgery. J Laparoendosc Adv Surg Tech A 10(5): 269–273PubMed
78.
Zurück zum Zitat Lane GE, Lathrop JC, Boysen DA, Lane RC (1996) Effect of intramuscular intraoperative pain medication on narcotic usage after laparoscopic holecystectomy. Am Surg 62: 907–910PubMed Lane GE, Lathrop JC, Boysen DA, Lane RC (1996) Effect of intramuscular intraoperative pain medication on narcotic usage after laparoscopic holecystectomy. Am Surg 62: 907–910PubMed
79.
Zurück zum Zitat Larsen JF, Ejstrud P, Kristensen JU, Svendsen F, Redke F, Pedersen V (2001) Randomized comparison of conventional and gasless laparoscopic cholecystectomy: operative technique, postoperative course, and recovery. J Gastrointest Surg 5(3): 330–335CrossRefPubMed Larsen JF, Ejstrud P, Kristensen JU, Svendsen F, Redke F, Pedersen V (2001) Randomized comparison of conventional and gasless laparoscopic cholecystectomy: operative technique, postoperative course, and recovery. J Gastrointest Surg 5(3): 330–335CrossRefPubMed
80.
Zurück zum Zitat Larsen JF, Svendsen FM, Ejstrud P, Kristensen JU, Pedersen V, Redke F (2002) [Gasless versus conventional laparoscopic cholecystectomy. A randomised trial with regard to technical problems, postoperative course and convalescence.]. Ugeskr Laeger 164(18): 2398–2402PubMed Larsen JF, Svendsen FM, Ejstrud P, Kristensen JU, Pedersen V, Redke F (2002) [Gasless versus conventional laparoscopic cholecystectomy. A randomised trial with regard to technical problems, postoperative course and convalescence.]. Ugeskr Laeger 164(18): 2398–2402PubMed
81.
Zurück zum Zitat Laurito CE, Kirz LI, VadeBoncouer TR, Riegler FX, Citron GM, Segil LJ, Pelligrino DA (1991) Continuous infusion of interpleural bupivacaine maintains effective analgesia after cholecystectomy. Anesth Analg 72: 516–521PubMed Laurito CE, Kirz LI, VadeBoncouer TR, Riegler FX, Citron GM, Segil LJ, Pelligrino DA (1991) Continuous infusion of interpleural bupivacaine maintains effective analgesia after cholecystectomy. Anesth Analg 72: 516–521PubMed
82.
Zurück zum Zitat Lee A, Boon D, Bagshaw P, Kempthorne P (1990) A randomised double-blind study of interpleural analgesia after cholecystectomy. Anaesthesia 46: 1028–1031 Lee A, Boon D, Bagshaw P, Kempthorne P (1990) A randomised double-blind study of interpleural analgesia after cholecystectomy. Anaesthesia 46: 1028–1031
83.
Zurück zum Zitat Lee I-O, Kim S-H, Kong M-H, Lee M-K, Kim N-S, Choi Y-S, Lim S-H (2001) Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine. Can J Anaesth 48(6): 545–550PubMed Lee I-O, Kim S-H, Kong M-H, Lee M-K, Kim N-S, Choi Y-S, Lim S-H (2001) Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine. Can J Anaesth 48(6): 545–550PubMed
84.
Zurück zum Zitat Leggett PL, Churchman-Winn R, Miller G (2000) Minimizing ports to improve laparoscopic cholecystectomy. Surg Endosc 14: 32–36CrossRefPubMed Leggett PL, Churchman-Winn R, Miller G (2000) Minimizing ports to improve laparoscopic cholecystectomy. Surg Endosc 14: 32–36CrossRefPubMed
85.
Zurück zum Zitat Lindgren L, Koivusalo AM, Kellokumpu I (1997) Gasless laparoscopic cholecystectomy. Abstract No. 52. Eur J Anaesthesiol 14: 61–103CrossRef Lindgren L, Koivusalo AM, Kellokumpu I (1997) Gasless laparoscopic cholecystectomy. Abstract No. 52. Eur J Anaesthesiol 14: 61–103CrossRef
86.
Zurück zum Zitat Lindgren L, Koivusalo A-M, Kellokumpu I (1995) Conventional pneumoperitoneum compared with abdominal wall lift for laparoscopic cholecystectomy. Br J Anaesth 75: 567–572PubMed Lindgren L, Koivusalo A-M, Kellokumpu I (1995) Conventional pneumoperitoneum compared with abdominal wall lift for laparoscopic cholecystectomy. Br J Anaesth 75: 567–572PubMed
87.
Zurück zum Zitat Liu J, Ding Y, White PF, Feinstein R, Shear JM (1993) Effects of ketorolac on pastoperative analgesia and ventilatory function after laparoscopic cholecystectomy. Anesth Analg 76: 1061–1066PubMed Liu J, Ding Y, White PF, Feinstein R, Shear JM (1993) Effects of ketorolac on pastoperative analgesia and ventilatory function after laparoscopic cholecystectomy. Anesth Analg 76: 1061–1066PubMed
88.
Zurück zum Zitat Look M, Chew SP, Tan YC, Liew SE, Cheong DMO, Tan JCH, Wee SB, Teh CH, Low CH (2001) Post-operative pain in needlescopic versus laparoscopic cholecystectomy: a prospective randomised trial. J R Coll Surg Edinb 46: 138–142PubMed Look M, Chew SP, Tan YC, Liew SE, Cheong DMO, Tan JCH, Wee SB, Teh CH, Low CH (2001) Post-operative pain in needlescopic versus laparoscopic cholecystectomy: a prospective randomised trial. J R Coll Surg Edinb 46: 138–142PubMed
89.
Zurück zum Zitat Luchetti M, Palomba R, Sica G, G. M, Tufano R (1996) Effectiveness and safety of combined epidural and general anesthesia for laparoscopic cholecystectomy. Reg Anesth 21(5): 465–469PubMed Luchetti M, Palomba R, Sica G, G. M, Tufano R (1996) Effectiveness and safety of combined epidural and general anesthesia for laparoscopic cholecystectomy. Reg Anesth 21(5): 465–469PubMed
90.
Zurück zum Zitat Lysak SZ, Anderson PT, Carithers RA, DeVane GG, Smith ML, Bates GW (1994) Postoperative effects of fentanyl, ketorolac and piroxicam as analgesics for outpatient laparoscopic procedures. Analg Laparosc 83(2): 270–275 Lysak SZ, Anderson PT, Carithers RA, DeVane GG, Smith ML, Bates GW (1994) Postoperative effects of fentanyl, ketorolac and piroxicam as analgesics for outpatient laparoscopic procedures. Analg Laparosc 83(2): 270–275
91.
Zurück zum Zitat Maestroni U, Sortini D, Devito C, Pour Morad Kohan Brunaldi F, Anania G, Pavanelli L, Pasqualucci A, Donini A (2002) A new method of preemptive analgesia in laparoscopic cholecystectomy. Surg Endosc 16(9): 1336–1340CrossRefPubMed Maestroni U, Sortini D, Devito C, Pour Morad Kohan Brunaldi F, Anania G, Pavanelli L, Pasqualucci A, Donini A (2002) A new method of preemptive analgesia in laparoscopic cholecystectomy. Surg Endosc 16(9): 1336–1340CrossRefPubMed
92.
Zurück zum Zitat Maidatsi P, Gorgias N, Zaralidou A, Ourailoglou V, Giala M (1998) Intercostal nerve blockade with a mixture of bupivacaine and phenol enhance the efficacy of intravenous patient-controlled analgesia in the control of post-cholecystectomy pain. Eur J Anaesthesiol 15: 529–534CrossRefPubMed Maidatsi P, Gorgias N, Zaralidou A, Ourailoglou V, Giala M (1998) Intercostal nerve blockade with a mixture of bupivacaine and phenol enhance the efficacy of intravenous patient-controlled analgesia in the control of post-cholecystectomy pain. Eur J Anaesthesiol 15: 529–534CrossRefPubMed
93.
Zurück zum Zitat Mathisen LC, Aasbo V, Raeder J (1999) Lack of pre-emotive analgesic effect of (R)-ketamine in laparoscopic cholecystectomy. Acta Anaesthesiol Scand 43: 220–224CrossRefPubMed Mathisen LC, Aasbo V, Raeder J (1999) Lack of pre-emotive analgesic effect of (R)-ketamine in laparoscopic cholecystectomy. Acta Anaesthesiol Scand 43: 220–224CrossRefPubMed
94.
Zurück zum Zitat McCrory CR, Lindahl SGE (2002) Cyclooxygenase inhibition for postoperative analgesia. Anesth Analg 95: 169–176CrossRefPubMed McCrory CR, Lindahl SGE (2002) Cyclooxygenase inhibition for postoperative analgesia. Anesth Analg 95: 169–176CrossRefPubMed
95.
Zurück zum Zitat McLaughlin (1994) The intraoperative administration of ketorolac tromethamine in evaluating length of stay in a same day surgery unit. J Am Assoc Nurse Anesthetists 62(5): 433–436 McLaughlin (1994) The intraoperative administration of ketorolac tromethamine in evaluating length of stay in a same day surgery unit. J Am Assoc Nurse Anesthetists 62(5): 433–436
96.
Zurück zum Zitat Michaloliakou C, Chung F, Sharma S (1996) Preoperative multimodal analgesia facilitates recovery after ambulatory laparoscopic cholecystectomy. Anesth Analg 82: 44–51CrossRefPubMed Michaloliakou C, Chung F, Sharma S (1996) Preoperative multimodal analgesia facilitates recovery after ambulatory laparoscopic cholecystectomy. Anesth Analg 82: 44–51CrossRefPubMed
97.
Zurück zum Zitat Moiniche S, Jorgensen H, Wetterslev J, Dahl JB (2000) Local anesthetic infiltration for postoperative pain relief after laparoscopy: a qualitive and quantitative systematic review of intraperito-neal, port-site infiltration and mesosalpinx block. Anesth Analg 90: 899–912CrossRefPubMed Moiniche S, Jorgensen H, Wetterslev J, Dahl JB (2000) Local anesthetic infiltration for postoperative pain relief after laparoscopy: a qualitive and quantitative systematic review of intraperito-neal, port-site infiltration and mesosalpinx block. Anesth Analg 90: 899–912CrossRefPubMed
98.
Zurück zum Zitat Moiniche S, Kehlet H, Dahl JB (2002) A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief: the role of timing of analgesia. Anesthesiology 96(3): 725–741CrossRefPubMed Moiniche S, Kehlet H, Dahl JB (2002) A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief: the role of timing of analgesia. Anesthesiology 96(3): 725–741CrossRefPubMed
99.
Zurück zum Zitat Moiniche S, Mikkelsen S, Wetterslev J, Dahl JB (1998) A qualitative systematic review of in-cisional local anaesthesia for postoperative pain relief after abdominal operations. Br J Anaesth 81 (3): 377–383 Moiniche S, Mikkelsen S, Wetterslev J, Dahl JB (1998) A qualitative systematic review of in-cisional local anaesthesia for postoperative pain relief after abdominal operations. Br J Anaesth 81 (3): 377–383
100.
Zurück zum Zitat Moore A, Edwards J, Barden J, McQuay H (2003) Bandolier’s little book of pain. Oxford: Oxford University Press Moore A, Edwards J, Barden J, McQuay H (2003) Bandolier’s little book of pain. Oxford: Oxford University Press
101.
Zurück zum Zitat Motamed C, Bouaziz H, Franco D, Benhamou D (2000) Analgesic effect of low-dose in-trathecal morphine and bupivacaine in laparoscopic cholecystectomy. Anaesthesia 55: 118–124CrossRefPubMed Motamed C, Bouaziz H, Franco D, Benhamou D (2000) Analgesic effect of low-dose in-trathecal morphine and bupivacaine in laparoscopic cholecystectomy. Anaesthesia 55: 118–124CrossRefPubMed
102.
Zurück zum Zitat Mouton WG, Bessell JR, Millard SH, Baxter PS, Maddern GJ (1999) A randomized controlled trial assessing the benefit of humififies insufflation fas during laparoscopic surgery. Surg Endosc 13: 106–108CrossRefPubMed Mouton WG, Bessell JR, Millard SH, Baxter PS, Maddern GJ (1999) A randomized controlled trial assessing the benefit of humififies insufflation fas during laparoscopic surgery. Surg Endosc 13: 106–108CrossRefPubMed
103.
Zurück zum Zitat Mraovic B, Jurisic T, Kogler-Majeric V, Sustic A (1997) Intraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 41: 193–196PubMed Mraovic B, Jurisic T, Kogler-Majeric V, Sustic A (1997) Intraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 41: 193–196PubMed
104.
Zurück zum Zitat Munoz HR, Guerrero ME, Brandes V, Cortinez LI (2002) Effect of timing of morphine administration during remifentanil-based anaesthesia on early recovery from anaesthesia and postoperative pain. Br J Anaesth 88(6): 814–818CrossRefPubMed Munoz HR, Guerrero ME, Brandes V, Cortinez LI (2002) Effect of timing of morphine administration during remifentanil-based anaesthesia on early recovery from anaesthesia and postoperative pain. Br J Anaesth 88(6): 814–818CrossRefPubMed
105.
Zurück zum Zitat Munro FJ, Young SJ, Broome IJ, Robb HM, Wardell GJ (1998) Intravenous tenoxicam for analgesia following laparoscopic cholecystectomy. Anaesth Intens Care 26: 56–60 Munro FJ, Young SJ, Broome IJ, Robb HM, Wardell GJ (1998) Intravenous tenoxicam for analgesia following laparoscopic cholecystectomy. Anaesth Intens Care 26: 56–60
106.
Zurück zum Zitat Murrell GO, Leake T, Hughes PJ (1996) A comparison of the efficacy of ketorolac and indo-metheacin for postoperative analgesia following laparoscopic surgery in day patients. Anaesth Intensive Care 24(2): 237–240PubMed Murrell GO, Leake T, Hughes PJ (1996) A comparison of the efficacy of ketorolac and indo-metheacin for postoperative analgesia following laparoscopic surgery in day patients. Anaesth Intensive Care 24(2): 237–240PubMed
107.
Zurück zum Zitat Naguib M, Attia M, Samarkandi AH (2000) Wound closure tramadol administration has a short-lived analgesic effect. Can J Anaesth 47(8): 815–818PubMed Naguib M, Attia M, Samarkandi AH (2000) Wound closure tramadol administration has a short-lived analgesic effect. Can J Anaesth 47(8): 815–818PubMed
108.
Zurück zum Zitat Naguib M, Seraj M, Attia M, Samarkandi AH, Seet M, Jaroudi R (1998) Perioperative antino-ciceptive effects of tramadol. A prospective, randomized, double-blind comparison with morphine. Can J Anaesth 45(12): 1168–1175PubMed Naguib M, Seraj M, Attia M, Samarkandi AH, Seet M, Jaroudi R (1998) Perioperative antino-ciceptive effects of tramadol. A prospective, randomized, double-blind comparison with morphine. Can J Anaesth 45(12): 1168–1175PubMed
109.
Zurück zum Zitat Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer HJ, Cuschieri A, Fuchs KH, Jacobi C, Jansen FW, Koivusalo AM, Lacy A, McMahon MJ, Millat B, Schwenk W (2002) The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc 16(7): 1121–1143CrossRefPubMed Neudecker J, Sauerland S, Neugebauer E, Bergamaschi R, Bonjer HJ, Cuschieri A, Fuchs KH, Jacobi C, Jansen FW, Koivusalo AM, Lacy A, McMahon MJ, Millat B, Schwenk W (2002) The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc 16(7): 1121–1143CrossRefPubMed
110.
Zurück zum Zitat O’Boyle CJ, deBeaux AC, Watson Dl, Ackroyd R, Lafullarde T, Leong JY, Williams JAR, Jamieson GG (2002) Helium vs carbon dioxide gas insufflation with or without saline lavage during laparoscopy. Surg Endosc 16: 620–625CrossRefPubMed O’Boyle CJ, deBeaux AC, Watson Dl, Ackroyd R, Lafullarde T, Leong JY, Williams JAR, Jamieson GG (2002) Helium vs carbon dioxide gas insufflation with or without saline lavage during laparoscopy. Surg Endosc 16: 620–625CrossRefPubMed
111.
Zurück zum Zitat O’Hanlon DM, Colbert S, Ragheb J, McEntee GP, Chambers F, Moriarty DC (2002) Intraperitoneal pethidine versus intramuscular pethidine for the relief of pain after laparoscopic cholecystectomy: randomized trial. World J Surg 26(12): 1432–1436CrossRefPubMed O’Hanlon DM, Colbert S, Ragheb J, McEntee GP, Chambers F, Moriarty DC (2002) Intraperitoneal pethidine versus intramuscular pethidine for the relief of pain after laparoscopic cholecystectomy: randomized trial. World J Surg 26(12): 1432–1436CrossRefPubMed
112.
Zurück zum Zitat Oxorn DC, Whatley GS (1989) Post-cholecystectomy pulmonary function following inteer-pleural bupivacaine and intramuscular pethidine. Anaeth Intensive Care 17: 440–443 Oxorn DC, Whatley GS (1989) Post-cholecystectomy pulmonary function following inteer-pleural bupivacaine and intramuscular pethidine. Anaeth Intensive Care 17: 440–443
113.
Zurück zum Zitat Ozkose Z, Ercan B, Unal Y, Yardim S, Kaymaz M, Dogulu F, Pasaoglu A (2001) Inhalation versus total intravenous anesthesia for lumbar disc herniation: comparison of hemodynamic effects, recovery characteristics, and cost. J Neurosurg Anesthesiol 13(4): 296–302CrossRefPubMed Ozkose Z, Ercan B, Unal Y, Yardim S, Kaymaz M, Dogulu F, Pasaoglu A (2001) Inhalation versus total intravenous anesthesia for lumbar disc herniation: comparison of hemodynamic effects, recovery characteristics, and cost. J Neurosurg Anesthesiol 13(4): 296–302CrossRefPubMed
114.
Zurück zum Zitat Paech MJ, Lee BH, Evans SF (2002) The effect of anaesthetic technique on postoperative nausea and vomiting after day-case gynaecological laparoscopy. Anaesth Intensive Care 30(2): 153–159PubMed Paech MJ, Lee BH, Evans SF (2002) The effect of anaesthetic technique on postoperative nausea and vomiting after day-case gynaecological laparoscopy. Anaesth Intensive Care 30(2): 153–159PubMed
115.
Zurück zum Zitat Papaziogas B, Arigiriadou H, Papagiannopoulou P, Pavlidis T, Georgiou M, Sfyra E, Pa-paziogas T (2001) Preincisional intravenous low-dose ketamine and local infiltration with ropiva-caine reduces postoperative pain after laparoscopic cholecystectomy. Surg Endosc 15: 1030–1033CrossRefPubMed Papaziogas B, Arigiriadou H, Papagiannopoulou P, Pavlidis T, Georgiou M, Sfyra E, Pa-paziogas T (2001) Preincisional intravenous low-dose ketamine and local infiltration with ropiva-caine reduces postoperative pain after laparoscopic cholecystectomy. Surg Endosc 15: 1030–1033CrossRefPubMed
116.
Zurück zum Zitat Pasqualucci A, Contardo R, Da Broi U, Colo F, Terrosu G, Donini A, Sorrentino M, Pasetto A, Bresadola F (1994) The effects of intraperitoneal local anesthetic on analgesic requirements and endocrine response after laparoscopic cholecystectomy: a randomized double-blind controlled study. J Laparoendosc Surg 4(6): 405–412PubMed Pasqualucci A, Contardo R, Da Broi U, Colo F, Terrosu G, Donini A, Sorrentino M, Pasetto A, Bresadola F (1994) The effects of intraperitoneal local anesthetic on analgesic requirements and endocrine response after laparoscopic cholecystectomy: a randomized double-blind controlled study. J Laparoendosc Surg 4(6): 405–412PubMed
117.
Zurück zum Zitat Pasqualucci A, De Angelis V, Contardo R, Colo F, Terrosu G, Donini A, Pasetto A, Bresadola F (1996) Preemptive analgesia: intraperitoneal local anesthetic in laparoscopic cholecystectomy. A randomized double-blind placebo-controlled study. Anesthesiology 85: 11–20CrossRefPubMed Pasqualucci A, De Angelis V, Contardo R, Colo F, Terrosu G, Donini A, Pasetto A, Bresadola F (1996) Preemptive analgesia: intraperitoneal local anesthetic in laparoscopic cholecystectomy. A randomized double-blind placebo-controlled study. Anesthesiology 85: 11–20CrossRefPubMed
118.
Zurück zum Zitat Paulson J, Mellinger J, Baguley W (2003) The use of intraperitoneal bupivacaine to decrease the length of stay in elective laparoscopic cholecystectomy patients. Am Surg 69(4): 275–278PubMed Paulson J, Mellinger J, Baguley W (2003) The use of intraperitoneal bupivacaine to decrease the length of stay in elective laparoscopic cholecystectomy patients. Am Surg 69(4): 275–278PubMed
119.
Zurück zum Zitat Perry CP, Tombrello R (1993) Effect of fluid instillation on postlaparoscopy pain. Journal of Reproductive Medicine 38(10): 768–771PubMed Perry CP, Tombrello R (1993) Effect of fluid instillation on postlaparoscopy pain. Journal of Reproductive Medicine 38(10): 768–771PubMed
120.
Zurück zum Zitat Power I, Noble DW, Douglas E, Spence AA (1990) Comparison of i.m. ketorolac trometamol and morphine sulphate for pain relief after cholecystectomy. Br J Anaesth 65: 448–455PubMed Power I, Noble DW, Douglas E, Spence AA (1990) Comparison of i.m. ketorolac trometamol and morphine sulphate for pain relief after cholecystectomy. Br J Anaesth 65: 448–455PubMed
121.
Zurück zum Zitat Puttick Ml, Scott-Coombes DM, Dye J, Nduka CC, Menzies-Gow NM, Mansfield AO, Darzi A (1999) Comparison of immunologic and physiologic effects of carbon dioxide pneumoperitoneum at room and body temperatures. Surg Endosc 13: 572–575CrossRefPubMed Puttick Ml, Scott-Coombes DM, Dye J, Nduka CC, Menzies-Gow NM, Mansfield AO, Darzi A (1999) Comparison of immunologic and physiologic effects of carbon dioxide pneumoperitoneum at room and body temperatures. Surg Endosc 13: 572–575CrossRefPubMed
122.
Zurück zum Zitat Quaynor H, Raeder JC (2002) Incidence and severity of postoperative nausea and vomiting are similar after metoclopramide 20 mg and ondansetron 8 mg given by the end of laparoscopic cholecystectomies. Acta Anaesthesiol Scand 46: 109–113CrossRefPubMed Quaynor H, Raeder JC (2002) Incidence and severity of postoperative nausea and vomiting are similar after metoclopramide 20 mg and ondansetron 8 mg given by the end of laparoscopic cholecystectomies. Acta Anaesthesiol Scand 46: 109–113CrossRefPubMed
123.
Zurück zum Zitat Rademaker BMP, Kalkman CJ, Odoom JA, de Wit L, Ringers J (1994) Intraperitoneal local anaesthetics after laparoscopic cholecystectomy: effects on postoperative pain, metabolic responses and lung function. Br J Anaesth 72: 263–266PubMed Rademaker BMP, Kalkman CJ, Odoom JA, de Wit L, Ringers J (1994) Intraperitoneal local anaesthetics after laparoscopic cholecystectomy: effects on postoperative pain, metabolic responses and lung function. Br J Anaesth 72: 263–266PubMed
124.
Zurück zum Zitat Rademaker BMP, Sih IL, Kalkman CJ, Henny CP, Filedt JC, Endert E, Zuurmond WWA (1991) Effects of interplerally administered bupivacaine 0.5% on opoid analgesic requirements and endocrine response during and after cholecystectomy: a randomized double-blind controlled study. Acta Anaesthesiol Scand 35: 108–112PubMed Rademaker BMP, Sih IL, Kalkman CJ, Henny CP, Filedt JC, Endert E, Zuurmond WWA (1991) Effects of interplerally administered bupivacaine 0.5% on opoid analgesic requirements and endocrine response during and after cholecystectomy: a randomized double-blind controlled study. Acta Anaesthesiol Scand 35: 108–112PubMed
125.
Zurück zum Zitat Raeder J, Mjaland O, Aasbo V, Grogaard B, Buanes T (1998) Desflurane versus propofol maintenance for outpatient laparoscopic cholecystectomy. Acta Anaesthesiol Scand 42: 106–110PubMed Raeder J, Mjaland O, Aasbo V, Grogaard B, Buanes T (1998) Desflurane versus propofol maintenance for outpatient laparoscopic cholecystectomy. Acta Anaesthesiol Scand 42: 106–110PubMed
126.
Zurück zum Zitat Raetzel M, Maier C, Schroder D, Wulf H (1995) Intraperitoneal application of bupivacaine during laparoscopic cholecystectomy—risk or benefit? Anesth Analg 81: 967–972CrossRefPubMed Raetzel M, Maier C, Schroder D, Wulf H (1995) Intraperitoneal application of bupivacaine during laparoscopic cholecystectomy—risk or benefit? Anesth Analg 81: 967–972CrossRefPubMed
127.
Zurück zum Zitat Roberts-Thompson IC, Jonsson JR, Frewin DB (1994) Sympathetic suppression attenuates anomalous responses to morphine in unexplained pain after cholecystectomy. Clin Auton Res 4: 185–188CrossRefPubMed Roberts-Thompson IC, Jonsson JR, Frewin DB (1994) Sympathetic suppression attenuates anomalous responses to morphine in unexplained pain after cholecystectomy. Clin Auton Res 4: 185–188CrossRefPubMed
128.
Zurück zum Zitat Rømsing J, Moiniche S, Dahl JB (2002) Rectal and parenteral paracetamol, and paracetamol in combination with NSAIDs, for postoperative analgesia. Br J Anaesth 88(2): 215–226CrossRefPubMed Rømsing J, Moiniche S, Dahl JB (2002) Rectal and parenteral paracetamol, and paracetamol in combination with NSAIDs, for postoperative analgesia. Br J Anaesth 88(2): 215–226CrossRefPubMed
129.
Zurück zum Zitat Rosenbaum M, Weller RS, Conrad PL, Falvey EA, Gross JB (1991) Ibuprofen provides longer lasting analgesia T=than fentanyl after laparoscopic surgery. Anesth Analg 73: 255–259PubMed Rosenbaum M, Weller RS, Conrad PL, Falvey EA, Gross JB (1991) Ibuprofen provides longer lasting analgesia T=than fentanyl after laparoscopic surgery. Anesth Analg 73: 255–259PubMed
130.
Zurück zum Zitat Rosenquist RW, Rosenberg J, United States Veterans Adminstration (2003) Postoperative pain guidelines. Reg Anesth Pain Med 28(4): 279–288CrossRefPubMed Rosenquist RW, Rosenberg J, United States Veterans Adminstration (2003) Postoperative pain guidelines. Reg Anesth Pain Med 28(4): 279–288CrossRefPubMed
131.
Zurück zum Zitat Ross WB, Tweedie JH, Leong YP, Wyman A, Smithers BM (1989) Intercoastal blockade and pulmonary function after cholecystectomy. Surgery 105(2): 166–169PubMed Ross WB, Tweedie JH, Leong YP, Wyman A, Smithers BM (1989) Intercoastal blockade and pulmonary function after cholecystectomy. Surgery 105(2): 166–169PubMed
132.
Zurück zum Zitat Rowlingson JC, Rawal N (2003) Postoperative pain guidelines—targeted to the site of surgery. Reg Anesth Pain Med 28(4): 265–267CrossRefPubMed Rowlingson JC, Rawal N (2003) Postoperative pain guidelines—targeted to the site of surgery. Reg Anesth Pain Med 28(4): 265–267CrossRefPubMed
133.
Zurück zum Zitat Saad S, Minor I, Mohri T, Nagelschmidt M (2000) The clinical impact of warmed insufflation carbon dioxide gas for laparoscopic cholecystectomy. Surg Endosc 14: 787–790CrossRefPubMed Saad S, Minor I, Mohri T, Nagelschmidt M (2000) The clinical impact of warmed insufflation carbon dioxide gas for laparoscopic cholecystectomy. Surg Endosc 14: 787–790CrossRefPubMed
134.
Zurück zum Zitat Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS (1996) Evidence based medicine: what it is and what it isn’t. Br Med J 312(7023): 71–72 Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS (1996) Evidence based medicine: what it is and what it isn’t. Br Med J 312(7023): 71–72
135.
Zurück zum Zitat Sarac AM, Aktan AO, Baykan N, Yegen C, Yalin R (1996) The effect and timing of local anesthesia in laparoscopic cholecystectomy. Surg Laparosc Endosc 6(5): 362–366CrossRefPubMed Sarac AM, Aktan AO, Baykan N, Yegen C, Yalin R (1996) The effect and timing of local anesthesia in laparoscopic cholecystectomy. Surg Laparosc Endosc 6(5): 362–366CrossRefPubMed
136.
Zurück zum Zitat Sarli L, Costi R, Sansebastiano G, Trivelli M, Roncoroni L (2000) Prospective randomized trial of low-pressure pneumoperitoneum for reduction of shouldre-tip pain following laparoscopy. Br J Surg 87: 1161–1165CrossRefPubMed Sarli L, Costi R, Sansebastiano G, Trivelli M, Roncoroni L (2000) Prospective randomized trial of low-pressure pneumoperitoneum for reduction of shouldre-tip pain following laparoscopy. Br J Surg 87: 1161–1165CrossRefPubMed
137.
Zurück zum Zitat Scheinin B, Kellokumpu I, Lindgren L, Haglund C, Rosenberg PH (1995) Effect of intraperito-neal bupivacaine on pain after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 39: 195–198PubMed Scheinin B, Kellokumpu I, Lindgren L, Haglund C, Rosenberg PH (1995) Effect of intraperito-neal bupivacaine on pain after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 39: 195–198PubMed
138.
Zurück zum Zitat Schroeder D, Baker P (1990) Interpleural catheter for analgesia after cholecystectomy: the surgical perspective. Aust N Z J Surg 60: 689–694PubMed Schroeder D, Baker P (1990) Interpleural catheter for analgesia after cholecystectomy: the surgical perspective. Aust N Z J Surg 60: 689–694PubMed
139.
Zurück zum Zitat Schulte-Steinberg H, Weninger E, Jokisch D, Hofstetter B, Misera A, Lange V, Stein C (1995) Intraperitoneal versus interpleural morphine or bupivacaine for pain after laparoscopic cholecystectomy. Anesthesiology 82(3): 634–640CrossRefPubMed Schulte-Steinberg H, Weninger E, Jokisch D, Hofstetter B, Misera A, Lange V, Stein C (1995) Intraperitoneal versus interpleural morphine or bupivacaine for pain after laparoscopic cholecystectomy. Anesthesiology 82(3): 634–640CrossRefPubMed
140.
Zurück zum Zitat Schulze S, Roikjaer O, Hasselstrom L, Jensen NH, Kehlet H (1988) Epidural bupivacaine and morphine plus systematic indomethacin eliminates pain but not systematic response and convalescence after cholecystectomy. Surgery 103(3): 321–327PubMed Schulze S, Roikjaer O, Hasselstrom L, Jensen NH, Kehlet H (1988) Epidural bupivacaine and morphine plus systematic indomethacin eliminates pain but not systematic response and convalescence after cholecystectomy. Surgery 103(3): 321–327PubMed
141.
Zurück zum Zitat Schwenk W, Mall JW, Neudecker J, Müller JM (2002) One visual analogue pain score is sufficient after laparoscopic cholecystectomy. Br J Surg 89: 114–115CrossRefPubMed Schwenk W, Mall JW, Neudecker J, Müller JM (2002) One visual analogue pain score is sufficient after laparoscopic cholecystectomy. Br J Surg 89: 114–115CrossRefPubMed
142.
Zurück zum Zitat Schwenk W, Neudecker J, Mall J, Böhm B, Müller JM (2000) Prospective randomized blinded trial of pulmonary function, pain, and cosmetic results after laparoscopic vs microlaparo-scopic cholecystectomy. Surg Endosc 14: 345–348CrossRefPubMed Schwenk W, Neudecker J, Mall J, Böhm B, Müller JM (2000) Prospective randomized blinded trial of pulmonary function, pain, and cosmetic results after laparoscopic vs microlaparo-scopic cholecystectomy. Surg Endosc 14: 345–348CrossRefPubMed
143.
Zurück zum Zitat Scott NB, Mogensen T, Bigler D, Kehlet H (1989) Comparison of the effects of continuous intrapleural vs epidural administration of 0.5% bupivacaine on pain, metabolic response and pulmonary function following cholecystectomy. Acta Anaesthesiol Scand 33: 535–539PubMed Scott NB, Mogensen T, Bigler D, Kehlet H (1989) Comparison of the effects of continuous intrapleural vs epidural administration of 0.5% bupivacaine on pain, metabolic response and pulmonary function following cholecystectomy. Acta Anaesthesiol Scand 33: 535–539PubMed
144.
Zurück zum Zitat Shah MV, Jones Dl, Rosen M (1986) “Patient demand” postoperative analgesia with bupre-norphine. Comparison between sublingual and i.m. adminstration. Br J Anaesth 58: 508–511PubMed Shah MV, Jones Dl, Rosen M (1986) “Patient demand” postoperative analgesia with bupre-norphine. Comparison between sublingual and i.m. adminstration. Br J Anaesth 58: 508–511PubMed
145.
Zurück zum Zitat Slim K, Bousquet J, Kwiatkowski F, Lescure G, Pezet D, Chipponi J (1999) Effect of carbon dioxide gas warming on pain after laparoscopic surgery: a randomized double-blind controlled trial. Surg Endosc 13: 1110–1114CrossRefPubMed Slim K, Bousquet J, Kwiatkowski F, Lescure G, Pezet D, Chipponi J (1999) Effect of carbon dioxide gas warming on pain after laparoscopic surgery: a randomized double-blind controlled trial. Surg Endosc 13: 1110–1114CrossRefPubMed
146.
Zurück zum Zitat Smith I, Ding Y, White PF (1993) Muscle pain after outpatient laparoscopy—lnfluence of profol versus thiopental and enflurane. Anesth Analg 76: 1181–1184PubMed Smith I, Ding Y, White PF (1993) Muscle pain after outpatient laparoscopy—lnfluence of profol versus thiopental and enflurane. Anesth Analg 76: 1181–1184PubMed
147.
Zurück zum Zitat Smythe M, Haubert K, Hoffman J, Dmuchowski C (1993) Comparison of three morphine regimens in postsurgical patients using patient-controlled analgesia. Ann Pharmacother 27: 691–694PubMed Smythe M, Haubert K, Hoffman J, Dmuchowski C (1993) Comparison of three morphine regimens in postsurgical patients using patient-controlled analgesia. Ann Pharmacother 27: 691–694PubMed
148.
Zurück zum Zitat Song D, Whitten CW, White PF (2000) Remifentanil infusion facilitates early recovery for obese outpatients undergoing laparoscopic cholecystectomy. Anesth Analg 90: 1111–1113CrossRefPubMed Song D, Whitten CW, White PF (2000) Remifentanil infusion facilitates early recovery for obese outpatients undergoing laparoscopic cholecystectomy. Anesth Analg 90: 1111–1113CrossRefPubMed
149.
Zurück zum Zitat Squirrell DM, Majeed AW, Troy G, Peacock JE, Nicholl JP, Johnson AG (1998) A randomized, prospective, blinded comparison of postoperative pain, metabolic response, and perceived health after laparoscopic and small incision cholecystectomy. Surgery 123(4): 485–495CrossRefPubMed Squirrell DM, Majeed AW, Troy G, Peacock JE, Nicholl JP, Johnson AG (1998) A randomized, prospective, blinded comparison of postoperative pain, metabolic response, and perceived health after laparoscopic and small incision cholecystectomy. Surgery 123(4): 485–495CrossRefPubMed
150.
Zurück zum Zitat Steffen P, Seeling W, Kunz R, Schuhmacher I, Georgieff M (1997) [Postoperative analgesia after endoscopic abdominal operations. A randomized double-blind study of peri-operative effectiveness of metamizole.]. Chirurg 68: 806–810CrossRefPubMed Steffen P, Seeling W, Kunz R, Schuhmacher I, Georgieff M (1997) [Postoperative analgesia after endoscopic abdominal operations. A randomized double-blind study of peri-operative effectiveness of metamizole.]. Chirurg 68: 806–810CrossRefPubMed
151.
Zurück zum Zitat Sternlo JE, Hagerfal M (1992) Perineuronal morphine in intercoastal block. Anaesthesia 47: 613–615PubMed Sternlo JE, Hagerfal M (1992) Perineuronal morphine in intercoastal block. Anaesthesia 47: 613–615PubMed
152.
Zurück zum Zitat Striebel WH, Koenigs Dl, Kramer JA (1993) Intravenous clonidine fails to reduce postoperative meperidine requirements. J Clin Anesth 5: 221–225CrossRefPubMed Striebel WH, Koenigs Dl, Kramer JA (1993) Intravenous clonidine fails to reduce postoperative meperidine requirements. J Clin Anesth 5: 221–225CrossRefPubMed
153.
Zurück zum Zitat Stromskag KE, Minor BG, Lindeberg A (1991) Comparison of 40 milliliters of 0.25% intra-pleural bupivacaine with epinephrine with 20 milliliters of 0.5% intrapleural bupivacaine with epi-nephrine after cholecystectomy. Anesth Analg 73: 397–400PubMed Stromskag KE, Minor BG, Lindeberg A (1991) Comparison of 40 milliliters of 0.25% intra-pleural bupivacaine with epinephrine with 20 milliliters of 0.5% intrapleural bupivacaine with epi-nephrine after cholecystectomy. Anesth Analg 73: 397–400PubMed
154.
Zurück zum Zitat Sung CS, Lin SH, Chan KH, Chang WK, Chow LH, Lee TY (2000) Effect of oral clonidine premedication on perioperative hemodynamic response and postoperative analgesic requirement for patients undergoing laparoscopic cholecystectomy. Acta Anaesthesiol Sin 38(1): 23–29PubMed Sung CS, Lin SH, Chan KH, Chang WK, Chow LH, Lee TY (2000) Effect of oral clonidine premedication on perioperative hemodynamic response and postoperative analgesic requirement for patients undergoing laparoscopic cholecystectomy. Acta Anaesthesiol Sin 38(1): 23–29PubMed
155.
Zurück zum Zitat Sveticic G, Gentilini A, Eichenberger U, Luginbuhl M, Curatolo M (2003) Combinations of morphine with ketamine for patient-controlled analgesia: a new optimization method. Anesthesiology 98(5): 1195–1205CrossRefPubMed Sveticic G, Gentilini A, Eichenberger U, Luginbuhl M, Curatolo M (2003) Combinations of morphine with ketamine for patient-controlled analgesia: a new optimization method. Anesthesiology 98(5): 1195–1205CrossRefPubMed
156.
Zurück zum Zitat Szem JW, Hydo L, Barie PS (1996) A double-blinded evaluation of intraperitoneal bupivacaine vs saline for the reduction of postoperative pain and nausea after laparoscopic surgery. Surg Endosd 10: 44–48CrossRef Szem JW, Hydo L, Barie PS (1996) A double-blinded evaluation of intraperitoneal bupivacaine vs saline for the reduction of postoperative pain and nausea after laparoscopic surgery. Surg Endosd 10: 44–48CrossRef
157.
Zurück zum Zitat Tarnow P, Cassuto J, Jonsson A, Rimback G, Hedman C (1998) Postoperative analgesia by D-myo-lnositol-1,2,6- trisphosphate in patients indergoing cholecystectomy. Anesth Analg 86: 107–110CrossRefPubMed Tarnow P, Cassuto J, Jonsson A, Rimback G, Hedman C (1998) Postoperative analgesia by D-myo-lnositol-1,2,6- trisphosphate in patients indergoing cholecystectomy. Anesth Analg 86: 107–110CrossRefPubMed
158.
Zurück zum Zitat Taylor E, Feinstein R, White PF, Soper N (1992) Anesthesia for laparoscopic cholecystectomy. Is nitrous oxide contraindicated. Anesthesiology 76: 541–543PubMed Taylor E, Feinstein R, White PF, Soper N (1992) Anesthesia for laparoscopic cholecystectomy. Is nitrous oxide contraindicated. Anesthesiology 76: 541–543PubMed
159.
Zurück zum Zitat Topcu O, Karakayali F, Kuzu MA, Ozdemir S, Erverdi N, Elhan A, Aras N (2003) Comparison of long-term quality of life after laparoscopic and open cholecystectomy. Surg Endosc 17(2): 291–295CrossRefPubMed Topcu O, Karakayali F, Kuzu MA, Ozdemir S, Erverdi N, Elhan A, Aras N (2003) Comparison of long-term quality of life after laparoscopic and open cholecystectomy. Surg Endosc 17(2): 291–295CrossRefPubMed
160.
Zurück zum Zitat Tsimoyiannis EC, Glantzounis G, Lekkas ET, Siakas P, Jabarin M, Tzourou H (1998) Intrap-eritoneal normal saline and bupivacaine infusion for reduction of postoperative pain after laparoscopic cholecystectomy. Surg Laparosc Endosc 8(6): 416–420CrossRefPubMed Tsimoyiannis EC, Glantzounis G, Lekkas ET, Siakas P, Jabarin M, Tzourou H (1998) Intrap-eritoneal normal saline and bupivacaine infusion for reduction of postoperative pain after laparoscopic cholecystectomy. Surg Laparosc Endosc 8(6): 416–420CrossRefPubMed
161.
Zurück zum Zitat Tsimoyiannis EC, Siakas P, Tassis A, Lekkas ET, Tzourou H, Kambili M (1998) Intraperito-neal normal saline infusion for postoperative pain after laparoscopic cholecystectomy. World J Surg 22: 824–828CrossRefPubMed Tsimoyiannis EC, Siakas P, Tassis A, Lekkas ET, Tzourou H, Kambili M (1998) Intraperito-neal normal saline infusion for postoperative pain after laparoscopic cholecystectomy. World J Surg 22: 824–828CrossRefPubMed
162.
Zurück zum Zitat Ure BM, Troidl H, Spangenberger W, Neugebauer E, Lefering R, Ullmann K, Bende J (1993) Preincisional local anesthesia with bupivacaine and pain after laparoscopic cholecystectomy. A double-blind randomized clinical trial. Surg Endosc 7: 482–488CrossRefPubMed Ure BM, Troidl H, Spangenberger W, Neugebauer E, Lefering R, Ullmann K, Bende J (1993) Preincisional local anesthesia with bupivacaine and pain after laparoscopic cholecystectomy. A double-blind randomized clinical trial. Surg Endosc 7: 482–488CrossRefPubMed
163.
Zurück zum Zitat Uzunkoy A, Coskun A, Akinci OF (1999) The application of local analgesia before and after surgery in laparoscopic cholecystectomy. Dolor 14: 287–289 Uzunkoy A, Coskun A, Akinci OF (1999) The application of local analgesia before and after surgery in laparoscopic cholecystectomy. Dolor 14: 287–289
164.
Zurück zum Zitat Uzunkoy A, Coskun A, Akinci OF (2001) The value of pre-emptive analgesia in the treatment of postoperative pain after laparoscopic cholecystectomy. Eur Surg Res 33: 39–41PubMed Uzunkoy A, Coskun A, Akinci OF (2001) The value of pre-emptive analgesia in the treatment of postoperative pain after laparoscopic cholecystectomy. Eur Surg Res 33: 39–41PubMed
165.
Zurück zum Zitat van Raay JJAM, Roukema JA, Lenderink BW (1992) Intraoperative wound infiltration with bupivacaine patients undergoing elective cholecystectomy. Arch Surg 127: 457–459PubMed van Raay JJAM, Roukema JA, Lenderink BW (1992) Intraoperative wound infiltration with bupivacaine patients undergoing elective cholecystectomy. Arch Surg 127: 457–459PubMed
166.
Zurück zum Zitat Varrassi G, Panella L, Piroli A, Marinangeli F, Varrassi S, Wolman I, Niv D (1994) The effects of perioperative ketorolac infusion on postoperative pain and endocrine-metabolic response. Anesth Analg 78: 514–519PubMed Varrassi G, Panella L, Piroli A, Marinangeli F, Varrassi S, Wolman I, Niv D (1994) The effects of perioperative ketorolac infusion on postoperative pain and endocrine-metabolic response. Anesth Analg 78: 514–519PubMed
167.
Zurück zum Zitat Verborgh C, Claeys M, Vanlersberghe C, Camu F (1994) Postoperative pain treatment after cholecystectomy with epidural sufentanil at lumbar or thoracic level. Acta Anaesthesiol Scand 38: 218–222PubMed Verborgh C, Claeys M, Vanlersberghe C, Camu F (1994) Postoperative pain treatment after cholecystectomy with epidural sufentanil at lumbar or thoracic level. Acta Anaesthesiol Scand 38: 218–222PubMed
168.
Zurück zum Zitat Vezakis A, Davides D, Gibson JS, Moore MR, Shah H, Larvin M, McMahon MJ (1999) Randomized comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy. Surg Endosc 13: 890–893CrossRefPubMed Vezakis A, Davides D, Gibson JS, Moore MR, Shah H, Larvin M, McMahon MJ (1999) Randomized comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy. Surg Endosc 13: 890–893CrossRefPubMed
169.
Zurück zum Zitat Visser K, Hassink EA, Bonsel GJ, Moen J, Kalkman CJ (2001) Randomized controlled trial of total intravenous anesthesia with propofol versus inhalation anesthesia with isoflurane–nitrous oxide: postoperative nausea with vomiting and economic analysis. Anesthesiology 95(3): 616–626CrossRefPubMed Visser K, Hassink EA, Bonsel GJ, Moen J, Kalkman CJ (2001) Randomized controlled trial of total intravenous anesthesia with propofol versus inhalation anesthesia with isoflurane–nitrous oxide: postoperative nausea with vomiting and economic analysis. Anesthesiology 95(3): 616–626CrossRefPubMed
170.
Zurück zum Zitat Wajima Z, Shitara T, Ishkawa G, Inoue T, Ogawa R (1998) Analgesia after upper abdominal surgery with extradural buprenorphine with lidocaine. Can J Anaesth 45(1): 28–33PubMed Wajima Z, Shitara T, Ishkawa G, Inoue T, Ogawa R (1998) Analgesia after upper abdominal surgery with extradural buprenorphine with lidocaine. Can J Anaesth 45(1): 28–33PubMed
171.
Zurück zum Zitat Wallace DH, Serpell MG, Baxter JN, O’Dwyer PJ (1997) Randomized trial of different insufflation pressures for laparoscopic cholecystectomy. Br J Surg 84: 455–458CrossRefPubMed Wallace DH, Serpell MG, Baxter JN, O’Dwyer PJ (1997) Randomized trial of different insufflation pressures for laparoscopic cholecystectomy. Br J Surg 84: 455–458CrossRefPubMed
172.
Zurück zum Zitat Wallin G, Cassuto J, Hogstrom S, HednerT (1988) Influence of intraperitoneal anesthesia on pain and the sympathoadrenal response to abdominal surgery. Acta Anaesthesiol Scand 32: 553–558PubMed Wallin G, Cassuto J, Hogstrom S, HednerT (1988) Influence of intraperitoneal anesthesia on pain and the sympathoadrenal response to abdominal surgery. Acta Anaesthesiol Scand 32: 553–558PubMed
173.
Zurück zum Zitat Wang JJ, Ho ST, Liu YH, Lee SC, Liu YC, Liao YC, Ho CM (1999) Dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy. Br J Anaesth 83(5): 772–775PubMed Wang JJ, Ho ST, Liu YH, Lee SC, Liu YC, Liao YC, Ho CM (1999) Dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy. Br J Anaesth 83(5): 772–775PubMed
174.
Zurück zum Zitat Wang JJ, Ho ST, Uen YH, Lin MT, Chen KT, Huang JC, Tzeng Jl (2002) Small-dose dexa-methasone reduces nausea and vomiting after laparoscopic cholecystectomy: a comparison of tro-pisetron with saline. Anesth Analg 95(1): 229–232CrossRefPubMed Wang JJ, Ho ST, Uen YH, Lin MT, Chen KT, Huang JC, Tzeng Jl (2002) Small-dose dexa-methasone reduces nausea and vomiting after laparoscopic cholecystectomy: a comparison of tro-pisetron with saline. Anesth Analg 95(1): 229–232CrossRefPubMed
175.
Zurück zum Zitat Weber A, Munoz J, Garteiz D, Cueto J (1997) Use of subdiaphtagmatic bupivacaine instillation to control postoperative pain after laparoscopic surgery. Surg Laparosc Endosc 7(1): 6–8CrossRefPubMed Weber A, Munoz J, Garteiz D, Cueto J (1997) Use of subdiaphtagmatic bupivacaine instillation to control postoperative pain after laparoscopic surgery. Surg Laparosc Endosc 7(1): 6–8CrossRefPubMed
176.
Zurück zum Zitat Weinbroum AA (2003) A single small dose of postoperative ketamine provides rapid and sustained improvement in morphine analgesia in the presence of morphine-resistant pain. Anesth Analg 96(3): 789–795CrossRefPubMed Weinbroum AA (2003) A single small dose of postoperative ketamine provides rapid and sustained improvement in morphine analgesia in the presence of morphine-resistant pain. Anesth Analg 96(3): 789–795CrossRefPubMed
177.
Zurück zum Zitat Weinbroum AA, Gorodezky A, Niv D, Ben-Abraham R, Rudick V, Szold A (2001) Dextro-methorphan attenuation of postoperative pain and primary anf secondary thermal hyperalgesia. Can J Anaesth 48(2): 167–174PubMed Weinbroum AA, Gorodezky A, Niv D, Ben-Abraham R, Rudick V, Szold A (2001) Dextro-methorphan attenuation of postoperative pain and primary anf secondary thermal hyperalgesia. Can J Anaesth 48(2): 167–174PubMed
178.
Zurück zum Zitat Westerling D, Luttropp HH, Holmin T, Landquist E (1997) Postoperative recovery after cholecystectomy by minilaparotomy: a randomized double-blind comparison between alpha-trinositol and placebo. Pharmacol Toxicol 81: 253–258PubMed Westerling D, Luttropp HH, Holmin T, Landquist E (1997) Postoperative recovery after cholecystectomy by minilaparotomy: a randomized double-blind comparison between alpha-trinositol and placebo. Pharmacol Toxicol 81: 253–258PubMed
179.
180.
Zurück zum Zitat Wilson YG, Rhodes M, Ahmed R, Daugherty M, Cawthorn SJ, Armstrong CP (1994) Intramuscular diclofenac sodium for postoperative analgesia laparoscopic cholecystectomy: a randomised, controlled trial. Surg Laparosc Endosc 4(5): 340–344PubMed Wilson YG, Rhodes M, Ahmed R, Daugherty M, Cawthorn SJ, Armstrong CP (1994) Intramuscular diclofenac sodium for postoperative analgesia laparoscopic cholecystectomy: a randomised, controlled trial. Surg Laparosc Endosc 4(5): 340–344PubMed
181.
Zurück zum Zitat Witjes WPJ, Crul BJP, Vollaard EJ, Joosten HJM, von Egmond J (1992) Application of sub-lingual buprenorphine in combination with naproxen or paracetamol for post-operative pain relief in choolecysrectomy patients in a double-blind study. Acta Anaesthesiol Scand 36: 323–327PubMed Witjes WPJ, Crul BJP, Vollaard EJ, Joosten HJM, von Egmond J (1992) Application of sub-lingual buprenorphine in combination with naproxen or paracetamol for post-operative pain relief in choolecysrectomy patients in a double-blind study. Acta Anaesthesiol Scand 36: 323–327PubMed
182.
Zurück zum Zitat Wu C-T, Yu J-C, Yeh C-C, Liu S-T, Li C-Y, Ho S-T, Wong C-S (1999) Preincisional dextro-methorphan treatment decreases postoperative pain and opioid requirement after laparoscopic cholecystectomy. Anesth Analg 88: 1131–1134PubMed Wu C-T, Yu J-C, Yeh C-C, Liu S-T, Li C-Y, Ho S-T, Wong C-S (1999) Preincisional dextro-methorphan treatment decreases postoperative pain and opioid requirement after laparoscopic cholecystectomy. Anesth Analg 88: 1131–1134PubMed
183.
Zurück zum Zitat Yotsui T, (2001) Clonidine premedication prevents sympathetic hyperactivity but does not prevent hypothalamo-pituitary-adrenocortical responses in patients undergoing laparoscopic cholecystectomy. J Anesth 15: 78–82CrossRefPubMed Yotsui T, (2001) Clonidine premedication prevents sympathetic hyperactivity but does not prevent hypothalamo-pituitary-adrenocortical responses in patients undergoing laparoscopic cholecystectomy. J Anesth 15: 78–82CrossRefPubMed
184.
Zurück zum Zitat Young J, O’Connell B (2001) Recovery following laparoscopic cholecystectomy in either a 23 hour or an 8 hour facility. J Qual Clin Pract 21(1–2): 2–7CrossRefPubMed Young J, O’Connell B (2001) Recovery following laparoscopic cholecystectomy in either a 23 hour or an 8 hour facility. J Qual Clin Pract 21(1–2): 2–7CrossRefPubMed
185.
Zurück zum Zitat Yu HP, Hseu SS, Yien HW, Teng YH, Chan KH (2003) Oral clonidine premedication preserves heart rate variability for patients undergoing larparoscopic cholecystectomy. Acta Anaesthesiol Scand 47(2): 185–190CrossRefPubMed Yu HP, Hseu SS, Yien HW, Teng YH, Chan KH (2003) Oral clonidine premedication preserves heart rate variability for patients undergoing larparoscopic cholecystectomy. Acta Anaesthesiol Scand 47(2): 185–190CrossRefPubMed
186.
Zurück zum Zitat Zmora O, Stolik-Dollberg O, Bar-Zakai B, Rosin D, Kuriansky J, Shabtai M, Perel A, Ayalon A (2000) Intraperitoneal bupivacaine does not attenuate pain following laparoscopic cholecystectomy. JSLS 4: 301–304PubMed Zmora O, Stolik-Dollberg O, Bar-Zakai B, Rosin D, Kuriansky J, Shabtai M, Perel A, Ayalon A (2000) Intraperitoneal bupivacaine does not attenuate pain following laparoscopic cholecystectomy. JSLS 4: 301–304PubMed
Metadaten
Titel
A procedure-specific systematic review and consensus recommendations for postoperative analgesia following laparoscopic cholecystectomy
verfasst von
H. Kehlet
A. W. Gray
F. Bonnet
F. Camu
H. B. J. Fischer
R. F. McCloy
E. A. M. Neugebauer
M. M. Puig
N. Rawal
C. J. P. Simanski
Publikationsdatum
01.10.2005
Erschienen in
Surgical Endoscopy / Ausgabe 10/2005
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-004-2173-8

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