Intraperitoneal local anesthetic agents in the management of postoperative pain

The instillation of local anesthetic into the peritoneal cavity at the time of various types of laparoscopic surgery has been found to improve postoperative pain as quantified by decreased time to discharge, decreased pain severity scores, and decreased amounts of rescue narcotic. No significant safety issues have been identified with the practice of intraperitoneal instillation of local anesthetic. Dosage, placement location and timing of local anesthetic administration has been evaluated in a variety of settings, for different procedures and prior to and after dissection. Although more research is needed to standardize the practice of intraperitoneal local anesthetic use, it has been demonstrated as helpful as an adjunct in managing the pain associated with laparoscopic surgery and should be considered for all patients undergoing laparoscopic surgery.