The impact of timing, type, and method of instillation of intraperitoneal local anaesthetic in laparoscopic abdominal surgery: a systematic review and network meta-analysis
Pooled result · Postoperative opioid consumptionResult — go to the resultMean difference −11.6 i.v. morphine equivalent doses 95% CrI −26.1 to 2.5Authors' conclusion
While aerosolised bupivacaine instilled at the end of surgery but before deflation of the pneumoperitoneum minimises postoperative opioid consumption, pain scores up to 24 h did not differ between the different modalities of delivering IPLA.
Study context
- Population
- Patients undergoing any laparoscopic abdominal surgery
- Participants
- 2,401 patients · 25 RCTs
- Comparison
- Combinations of type, timing and method (aerosol vs liquid) of intraperitoneal local anaesthetic (IPLA) instillation
- Outcome
- Cumulative opioid consumption and pain (overall and shoulder)
- Follow-up
- Up to 24 h after surgery
Methodological detailsGrading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment
- GRADE assessment
Pooled result
Postoperative opioid consumption
Mean difference
−11.6 i.v. morphine equivalent doses
95% CrI −26.1 to 2.5
Aerosolised bupivacaine, end of surgery vs Liquid levobupivacaine, before surgery
mean difference −11.6 i.v. morphine equivalent doses (95% CrI −26.1 to 2.5)
As reported in the abstract
Original publication
The impact of timing, type, and method of instillation of intraperitoneal local anaesthetic in laparoscopic abdominal surgery: a systematic review and network meta-analysis. Br J Anaesth. Published 21 December 2023. doi:10.
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