Intraperitoneal Techniques of Local Anaesthesia During Laparoscopic Cholecystectomy
Efficacy of Intraperitoneal Local Anaesthetic Techniques During Laparoscopic Cholecystectomy: A Double Blind Randomized Controlled Trial
Pain following laparoscopic cholecystectomy (LC) results in morbidity and is a barrier to same day discharge. In several trials local anaesthetic (LA) washed over the liver and gall bladder decreases pain. In many patients pain has a strong component attributable to diaphragmatic origin. A wash of LA over the liver and gall bladder is unlikely to provide high levels of analgesia to pain fibres from the diaphragm. The investigators hypothesise that LA injected to the right hemidiaphragm during LC would be more effective than wash.
Methods Double blind randomised controlled trial of 128 consecutive subjects undergoing elective LC. Control -sham injection of diaphragm and sham wash over liver/GB with saline; Test treatment 'subperitoneal LA' - bupivocaine injection/sham wash; Internal control 'topical LA' - sham injection/bupivocaine wash. Primary outcome: pain scores in theatre recovery and the ward. Secondary outcomes: analgesic use, physiological observations, time to eating and mobilising, day case surgery.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Warwickshire
-
Coventry, Warwickshire, United Kingdom, CV2 2DX
- UHCW NHS Trust
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Elective laparoscopic cholecystectomy
- 18 years old or over
Exclusion Criteria:
- Emergency surgery
- Under 18 year olds
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Sham Comparator: Control
Sham wash, sham injection
|
20ml 0.9% NaCl
Other Names:
|
|
Experimental: Subperitoneal injection
Local anaesthetic injection to diaphragm with sham wash over liver and gall bladder
|
20ml 0.25% at beginning of operation
Other Names:
|
|
Active Comparator: Topical LA
Local anaesthetic washed over gall bladder and liver.
Sham injection of diaphragm
|
20ml 0.25% at beginning of operation
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
VAS pain score
Time Frame: 1, 4, 8 hours after operation and at discharge
|
1, 4, 8 hours after operation and at discharge
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to ambulation
Time Frame: following the procedure
|
The first time the patient gets out of bed and walks following the procedure
|
following the procedure
|
|
Same day discharge
Time Frame: 24 hours
|
24 hours
|
|
|
VRS pain scores
Time Frame: Every 10 minutes in theatre recovery
|
Immediately following the operation
|
Every 10 minutes in theatre recovery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Keith J Roberts, MRCS, University Hospital Coventry and Warwickshire NHS Trust
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pathological Conditions, Anatomical
- Gallbladder Diseases
- Biliary Tract Diseases
- Calculi
- Cholelithiasis
- Cholecystolithiasis
- Gallstones
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Sensory System Agents
- Anesthetics
- Anesthetics, Local
- Bupivacaine
Other Study ID Numbers
Other Study ID Numbers
- UHCW 1
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