{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:33:28Z","timestamp":1787772808071,"version":"build-2784847793"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Laparoscopic surgery in recent times has noteworthy advantages over conventional surgery, yet recovery is prolonged due to debilitating shoulder tip pain (STP) and operated site pain. Various studies have compared the effect of trocar site, intraperitoneal instillation of local anesthetic (LA) for pain relief while only a few studies have tested the combination of these two techniques. Hence, this study was undertaken to compare the combination of these two techniques versus trocar site alone for STP particularly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods:<\/jats:title>\n                    <jats:p>\n                      This prospective, randomized, comparative study was conducted on 52 patients who were undergoing laparoscopic abdominal surgery. The patients were allocated into either of the two groups. Group I (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 26): trocar site infiltration (20 mL) and intraperitoneal instillation (20 mL) of 0.25% levobupivacaine and Group II (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 26): trocar site infiltration (20 mL) of 0.25% levobupivacaine and saline (20 mL) intraperitoneally. Postoperative STP was the primary outcome while surgical site pain, nausea, and vomiting were secondary outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were no statistically significant differences between the groups with regard to shoulder pain, surgical site pain, total rescue analgesics, and incidence of nausea and vomiting (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Trocar site infiltration with intraperitoneal instillation of LA or trocar site infiltration alone was found to be equally effective. However, we suggest that it is better to provide a combination of trocar site infiltration plus intraperitoneal instillation of LA if we have to restrict opioid usage such as in day-care surgeries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aer.aer_156_21","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T08:40:01Z","timestamp":1646728801000},"page":"375-378","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of Trocar Site versus Trocar Site Plus Intraperitoneal Instillation of Local Anesthetic for Shoulder Pain Following Laparoscopic Abdominal Surgery"],"prefix":"10.4103","volume":"15","author":[{"given":"Sheerin Sarah","family":"Lysander","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Dilip","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusha","family":"Balasubramanian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajarajeswaran","family":"Krishnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. S.","family":"Raghuraman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Vijay","family":"Narayanan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-7-20240901","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1097\/JCMA.0000000000000190","article-title":"Pain after laparoscopic surgery: Focus on shoulder-tip pain after gynecological laparoscopic surgery","volume":"82","author":"Sao","year":"2019","journal-title":"J Chin Med Assoc"},{"key":"R2-7-20240901","doi-asserted-by":"crossref","first-page":"306","DOI":"10.5152\/TJAR.2016.75983","article-title":"Comparison of intraabdominal and trocar site local anaesthetic infiltration on postoperative analgesia after laparoscopic cholecystectomy","volume":"44","author":"Altunta\u015f","year":"2016","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"R3-7-20240901","doi-asserted-by":"crossref","first-page":"173","DOI":"10.4103\/0972-9941.83508","article-title":"Intraincisional vs intraperitoneal infiltration of local anaesthetic for controlling early post-laparoscopic cholecystectomy pain","volume":"7","author":"El-Labban","year":"2011","journal-title":"J Minim Access Surg"},{"key":"R4-7-20240901","doi-asserted-by":"crossref","first-page":"377","DOI":"10.4103\/aer.AER_6_18","article-title":"Intraperitoneal instillation of bupivacaine and ropivacaine for postoperative analgesia in laparoscopic cholecystectomy","volume":"12","author":"Sharan","year":"2018","journal-title":"Anesth Essays Res"},{"key":"R5-7-20240901","doi-asserted-by":"crossref","first-page":"355","DOI":"10.4103\/aer.AER_205_17","article-title":"Intraperitoneal levobupivacaine alone or with dexmedetomidine for postoperative analgesia after laparoscopic cholecystectomy","volume":"12","author":"Beder El Baz","year":"2018","journal-title":"Anesth Essays Res"},{"key":"R6-7-20240901","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/S0002-9610(98)00150-0","article-title":"A prospective randomized trial of intraoperative bupivacaine irrigation for management of shoulder-tip pain following laparoscopy","volume":"176","author":"Cunniffe","year":"1998","journal-title":"Am J Surg"},{"key":"R7-7-20240901","first-page":"CD011101","article-title":"Interventions to reduce shoulder pain following gynaecological laparoscopic procedures","volume":"1","author":"Kaloo","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"R8-7-20240901","doi-asserted-by":"crossref","first-page":"80","DOI":"10.5152\/TJAR.2014.06025","article-title":"Post-laparoscopic cholecystectomy pain: Effects of preincisional infiltration and intraperitoneal levobupivacaine 0.25% on pain control-a randomized prospective double-blinded placebo-controlled trial","volume":"42","author":"Karaman","year":"2014","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"R9-7-20240901","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1007\/s00464-005-3002-4","article-title":"Postoperative pain relief after laparoscopic cholecystectomy: A placebo-controlled double-blind randomized trial of preincisional infiltration and intraperitoneal instillation of levobupivacaine 0.25%","volume":"19","author":"Louizos","year":"2005","journal-title":"Surg Endosc"},{"key":"R10-7-20240901","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1002\/bjs.7435","article-title":"Randomized clinical trial of combined preincisional infiltration and intraperitoneal instillation of levobupivacaine for postoperative pain after laparoscopic cholecystectomy","volume":"98","author":"Hilvering","year":"2011","journal-title":"Br J Surg"},{"key":"R11-7-20240901","doi-asserted-by":"crossref","first-page":"239","DOI":"10.5152\/TJAR.2017.43078","article-title":"Comment on: Comparison of intraabdominal and trocar site local anaesthetic infiltration on postoperative analgesia after laparoscopic cholecystectomy","volume":"45","author":"Raghuraman","year":"2017","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"R12-7-20240901","doi-asserted-by":"crossref","first-page":"3615","DOI":"10.2147\/JPR.S338716","article-title":"Sodium bicarbonate sub-diaphragmatic irrigation relieves shoulder pain after total laparoscopic hysterectomy: A randomized controlled trial","volume":"14","author":"Liu","year":"2021","journal-title":"J Pain Res"}],"container-title":["Anesthesia Essays &amp; 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