Preemptive Analgesia in Single-Incision Laparoscopic Surgery

cision is closely associated with postoperative wound pain [9]. The single umbilical incisions reported in other studies typically reached lengths of 15 to 20 mm. Although postoperative pain has not been a major concern since the introduction of the routine laparoscopic cholecystectomy (LC), supporters of a single-incision LC (SILC) advocate the hypothesis that a reduction in the number of incisions may result in lower postoperative pain. On the other hand, some authors believe that the SILC increases postoperative pain because of the additional stress on the port incision necessary to allow triangulation of the instruments and exposure or the longer incision at the port site. Previous meta-analyses showed no difference in pain on the day after surgery between the two approaches. In the present meta-analysis, no differences in postoperative pain were found up to 30 days after surgery [10]. The study of Ahn et al. [11] aimed to determine the efficacy of preincisional bupivacaine infiltration as preemptive analgesia in postoperative pain relief after an appendectomy especially in single-incision laparoscopic surgery. Bupivacaine, 0.5%, was used as the local anesthetic for preincisional infiltration because it has a longer half-life than lidocaine and it has potential advantages for the relief of postoperative pain [12]. The study showed that preincisional bupivacaine infiltration was an effective and simple method of reducing postoperative pain for patients undergoing a SILS-appendectomy. Administration of preincisional bupivacaine infiltration may be worth considering for all patients undergoing an appendectomy, and it may be extended to other elective surgery as well.