The Silent Relief: Study Unveils Efficacy of Intraperitoneal Local Anesthetics in Postoperative Pain Management

Written by Dr Monish Raut Published On 2025-09-01T20:45:35+05:30 | Updated On 1 Sept 2025 8:46 PM IST

The Silent Relief: Study Unveils Efficacy of Intraperitoneal Local Anesthetics in Postoperative Pain Management

Recent scientific study looked into the use of local anesthetic medications administered directly into the abdominal cavity to manage pain after abdominal surgery. While this method is commonly used, its effectiveness and safety have been unclear. The researchers conducted a systematic review and meta-analysis of various studies to evaluate how well these medications work for postoperative pain control. The study found that intraperitoneal local anesthetics (IPLA) were associated with a small reduction in postoperative pain intensity up to 48 hours after surgery. Patients who received IPLA also tended to use less opioid pain medication at 24 hours post-surgery, experienced less nausea and vomiting, and had a quicker recovery of gastrointestinal transit. However, there was no significant impact on the length of hospital stay or the overall quality of recovery. It is important to note that the level of evidence supporting the use of IPLA was considered to be low to very low. This means that while there were some positive effects observed, there was insufficient data on potential side effects and long-term outcomes. The researchers recommended further studies to better understand the risks and benefits of using IPLA as a routine pain management strategy after abdominal surgery. Overall, the study suggested that using local anesthetics directly into the abdominal cavity could provide some relief for postoperative pain, but due to the limited evidence available, it is not yet recommended as a standard practice. More research is needed to fully assess the safety and long-term effects of this approach before it can be widely adopted in clinical settings.

Key Points –

- -Effectiveness of Intraperitoneal Local Anesthetics (IPLA):- The systematic review and meta-analysis found that IPLA is associated with a statistically significant reduction in postoperative abdominal pain intensity when compared to control groups at multiple time points (6, 12, 24, and 48 hours post-surgery), suggesting it may provide a small short-term analgesic effect. However, the clinical significance remains unclear due to the low certainty of the evidence.

- -Reduction in Opioid Consumption:- IPLA was linked to a significant decrease in opioid use at 24 hours after surgery, with an average reduction of approximately 10.4 mg of oral morphine equivalent. However, no substantial reduction in opioid use was observed at the 48-hour mark, indicating that the benefit may be short-lived.

- -Impact on Nausea and Vomiting:- The administration of IPLA led to a notable reduction in the incidence of postoperative nausea and vomiting, with a 21% lower risk (relative risk of 0.79). This effect was consistent across various types of surgeries, suggesting a beneficial outcome of IPLA in managing these common postoperative complications.

- -Gastrointestinal Recovery:- There was a reported decrease in time to gastrointestinal transit recovery associated with IPLA, with an average reduced time of approximately 3.8 hours. However, the certainty of this evidence is low, given the limited number of studies contributing to this finding.

- -No Effect on Hospital Stay and Quality of Recovery:- The analysis showed no significant differences in hospital length of stay and quality of recovery between groups receiving IPLA and control groups. This suggests that while IPLA may alleviate pain and nausea, it does not appear to influence overall recovery metrics or hospitalization duration.

- -Low Certainty of Evidence and Need for Further Research:- Despite some promising outcomes related to pain management and nausea reduction, the evidence supporting the use of IPLA is considered low to very low quality. The study calls for more rigorous randomized controlled trials to better evaluate adverse effects and long-term outcomes related to IPLA to definitively determine its role in standard postoperative care after intra-abdominal surgeries.

Reference –

M. Boulianne et al. (2025). Intraperitoneal Local Anesthetics For Postoperative Pain Management Following Intra-Abdominal Surgery: A Systematic Review And Meta-Analysis. *BMC Anesthesiology*, 25. https://doi.org/10.1186/s12871-025-03105-y.

Systematic reviewMeta-analysisSurgeryIntraperitoneal anesthesiaLocal anesthetics

Dr Monish Raut

MBBS, MD (Anaesthesiology), FNB (Cardiac Anaesthesiology)

Dr Monish Raut is a practicing Cardiac Anesthesiologist. He completed his MBBS at Government Medical College, Nagpur, and pursued his MD in Anesthesiology at BJ Medical College, Pune. Further specializing in Cardiac Anesthesiology, Dr Raut earned his FNB in Cardiac Anesthesiology from Sir Ganga Ram Hospital, Delhi.