To the Editor Postoperative pain after laparoscopic surgery is one of the major concerns of patients.1 Improper pain management could be associated with varied respiratory, cardiovascular, gastrointestinal, and psychological complications. Thromboembolic events could occur following reduced mobility due to postoperative pain. Furthermore, activation of stress responses can lead to water and sodium retention and an increased metabolic rate.2 Gough et al1 suggest that after mesh placement (ie, after laparoscopic ventral hernia repair), a long-acting local anesthetic (bupivacaine hydrochloride, 0.50%) injected between the mesh and the peritoneum significantly reduced early postoperative pain and narcotic requirements.
Golzari SEJ, Nader ND, Mahmoodpoor A. Underlying Mechanisms of Postoperative Pain After Laparoscopic Surgery. JAMA Surg. 2016;151(3):295-296. doi:10.1001/jamasurg.2015.3934