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Comment & Response
March 2016

Underlying Mechanisms of Postoperative Pain After Laparoscopic Surgery

Author Affiliations
  • 1Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  • 2Department of Anesthesiology, State University of New York at Buffalo, Buffalo, New York
  • 3Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
JAMA Surg. 2016;151(3):295-296. doi:10.1001/jamasurg.2015.3934

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.

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