Laparoscopic Cholecystectomy 2005

TOPICS FOR FUTURE RESEARCH

In certain circumstances, recommendations for a type of treatment cannot be made due to limited or conflicting evidence. Areas which have been identified as requiring further investigation in the future are as follows:

• Time of drug administration, e.g.:
  • pre- versus post-incisional administration of various agents, such as conventional NSAIDs, COX-2-selective inhibitors, paracetamol
  • IP LA instillation at the start of surgery versus administration at the end of surgery
• IV LA infusion
• Alpha-2-adrenergic receptor agonists
• Dextromethorphan
• Ketamine
• Interpleural local anaesthetic
• Intra-operative fluid management
• Postoperative PCA IP local anaesthetic
• Humidified and/or warmed pneumoperitoneum
• Nitrous oxide pneumoperitoneum
• Total size of trocar incision
• Radially expanding trocars
• Surgeon’s position
• Subhepatic drains
• Aspiration of the pneumoperitoneum gas