***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Some scientific studies , with controversial results , have evaluated the efficacy in reducing pain of some different local anesthetic molecules , which were administered at different dosages and in different ways . The primary goal of this r and omized , controlled , prospect i ve study ( Clinical Trials.gov ID NCT00599144 ) was to assess the effectiveness of 0.5 % bupivacaine for pain control after video-laparoscopic cholecystectomy at its optimal dosage of 2 mg/kg infiltrated in the muscular fasciae of the trocars , or positioned in the gallbladder soaking a sheet of regenerated oxidized cellulose ( Tabotamp ® ) . Methods A total of 45 patients underwent elective video-laparoscopic cholecystectomy .  They were r and omized in three groups each made of 15 patients : group A ( bupivacaine-soaked Tabotamp ® positioned in the gallbladder bed ) , group B ( bupivacaine infiltrated in the muscular fasciae of the trocars ’ seat ) , group C ( control group , not using local anesthetic ) . Six and twenty-four hours after the intervention , the nature of the pain and its intensity were recorded with the use of a Visual Analogue Scale ( VAS ) . Results Six hours after the intervention , VAS average was 29.6 ± 10.92 for group A , 25.86 ± 16.06 for group B , and 36.13 ± 16.62 for group C. At 24 h , we recorded 19.26 ± 15.81 , 18.53 ± 12.3 , and 20.46 ± 20.08 for groups A , B , and C , respectively ( p > 0.05 ) . Comparing groups A and B between them and with the control group at 6 and 24 h , we deduced how only the first group showed a statistically significant advantage ( p < 0.05 ) in reducing visceral and shoulder pain compared with the two other groups . Wound infiltration result ed in being statistically favorable in reducing parietal pain only when compared with Group A. For groups A and B , bupivacaine significantly reduced the use of postoperative pain killers . Conclusion Bupivacaine , either infiltrated in trocars ’ wounds or kept soaked in a regenerated oxidized cellulose sheet positioned in the gallbladder bed , although safe and not economically dem and ing , can increase postoperative comfort Background The aim of this study was to test the use of preincisional and intraperitoneal levobupivacaine ( L-B ) 0.25 % in laparoscopic cholecystectomies for postoperative analgesia . Methods A total of 108 patients under general anesthesia were r and omly assigned to receive preincisional local infiltration of 20 ml solution and intraperitoneal instillation of another 20 ml solution . Group A received for local infiltration and intraperitoneal instillation normal saline ( NS ) . Group B received for local infiltration L-B 0.25 % and for intraperitoneal instillation NS . Group C received for local infiltration NS and for intraperitoneal instillation L-B 0.25 % . Group D received both for local infiltration and intraperitoneal instillation L-B 0.25 % . Abdominal and right shoulder pain were recorded for 24 h postoperatively . Results The pain scores were lower in group D than in the other groups during rest , cough , and movement ( p < 0.05 ) . Rescue analgesic treatment was significantly lower in patients of group D ( 35 % ) as compared with that of group A ( 84 % ) ( p < 0.05 ) . The incidence of right shoulder pain was significantly lower in groups C ( 22 % ) and D ( 18 % ) than in any of the other groups ( p < 0.05 ) . Conclusions The combination of preincisional local infiltration and intraperitoneal instillation of L-B 0.25 % shows an advantage for postoperative analgesia after laparoscopic cholecystectomy BACKGROUND Following laparoscopic cholecystectomy , an effective post-operative pain control is necessary , at least during the first 24 hours . We present a r and omized , double-blind trial on the effect of the combined use of intravenous parecoxib , and metamizol or paracetamol on piritramide consumption using a patient-controlled analgesia ( PCA ) pump in patients recovering from laparoscopic cholecystectomy . METHODS 120 patients were r and omly allocated to four patient groups treated with normal saline or one of non-opioid analgesics ( parecoxib 40 mg twice daily , metamizol 1 g three times daily , paracetamol 1 g three times daily ) in addition to piritramide using the PCA pump . Beginning in the post-anesthesia care unit ( PACU ) , patients were asked every 2 h for 6 hours and afterwards once every 6 h to quantify their pain experience at rest while piritramide consumption was recorded . RESULTS In all groups , piritramide consumption was high in PACU . Only metamizol significantly reduced piritramide consumption compared to the others upon discharge from PACU . Overall , cumulative piritramide consumption was slightly lower in the metamizol group and higher in the NaCl group ; however , these findings were statistically not significant . VAS scores were highest upon arrival in PACU and dropped almost continuously after surgery . A significantly lower postoperative pain intensity was only found in the parecoxib group at 24 h after surgery compared to the metamizol group . CONCLUSION The efficacy of tested additive medications on piritramide consumption and pain relief is weak and there is no clear-cut difference between the non-opioid drugs used BACKGROUND The complexity of pain after laparoscopic cholecystectomy ( LC ) needs multi-module analgesia . Opioids are widely used for perioperative pain but associated with numerous adverse effects . We investigated the effect of parecoxib administrated preoperatively and postoperatively for analgesia after ambulatory laparoscopic cholecystectomy . METHODS 120 patients scheduled for ambulatory LC with general anesthesia were r and omly assigned to three groups : group A received 40 mg parecoxib injection 30 - 45 min before anesthesia induction and 4 ml saline injection when gallbladder was removed ; group B received 4 ml saline injection 30 - 45 min before anesthesia induction and 40 mg parecoxib injection when gallbladder was removed ; group C received 4 ml saline injection 30 - 45 min before anesthesia induction and the time when gallbladder was removed . We recorded the time achieve to modified Aldrete 's score > 9 in the post-anesthesia care unit ( PACU ) and modified Post-Anesthetic Discharge Scoring System ( PADSS ) > 9 in ambulatory unit . The visual analog scale ( VAS ) was used to assess the degree of the postoperative pain in the first 24 h , and the numbers of patients who need additional analgesic and postoperative adverse effects were also recorded . RESULTS Patients of group A had a shorter length of stay ( LOS ) in PACU compared to these of group B and group C ( 32.4 ± 7.2 min vs. 39.1 ± 10.4 min and 42.2 ± 7.6 min , P < 0.05 ) . Patients of group A also had a shorter discharge time compared to these of group B and group C ( 148.4 ± 39.3 min vs. 187.9 ± 47.7 min and 223.4 ± 52.5 min , P < 0.05 ) . Moreover , patients of group A experienced reduced pain intensity , less postoperative side effect , and less additional analgesic requirement . CONCLUSION Preoperative administration of parecoxib for postoperative analgesia provided significant effect on reducing PACU length of stay ( LOS ) and discharge time , and improving patient outcome after ambulatory LC AIM To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy . METHODS A prospect i ve , double-blind , r and omized , placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital , Bangkok , from January 2006 to December 2007 . Patients were r and omized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose ( treatment group ) , or normal saline infusion , in the same schedule , as a placebo ( control group ) . The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery , and then every 12 h the following day , using a visual analog scale . The consumption of analgesics was also recorded . RESULTS There were 40 patients in the treatment group , and 30 patients in the control group . The pain scores at each time point , and analgesic consumption did not differ between the two groups . However , there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h ( 60 % vs 37 % , P = 0.053 ) . CONCLUSION Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy . However , preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption BACKGROUND Pain is the most common complaint of patients on the first day after laparoscopic cholecystectomy ( LC ) . The aim of this study was to compare the efficacy of local anesthesia with bupivacaine and intravenous parecoxib on postoperative abdominal pain relief up to 24 h after surgery . METHODS One hundred and eighty patients who underwent LC were r and omized to one of three groups with sixty patients each : Group A received 50 mg 0.5 % bupivacaine subcutaneously at trocar sites before incision closure ; Group B received intravenous parecoxib ( 40 mg ) after entering the recovery room ; Group C did not receive postoperative analgesia unless needed and was served as control . The postoperative pain at 1 , 2 , 4 , 8 , 12 , and 24 h after the operation was assessed using a visual analog scale ( VAS ) . Secondary outcomes , including intraoperative and postoperative complications , the incidence of shoulder pain , pethidine requirements , postoperative nausea and vomiting , and hospital stay were also recorded . RESULTS At 1 , 2 , and 4 hours after surgery , VAS pain scores were significantly lower in group A and B compared with group C ( P < 0.05 for all ) . There was no significant difference among the three groups at 8 , 12 , and 24 hours after the procedure ( P > 0.05 for all ) . A repeated- measures ANOVA analysis revealed that VAS pain scores over the first 24 hours after LC were significantly lower in group A and B compared with group C ( P = 0.014 and P = 0.029 for between-group comparison , respectively ) . Furthermore , the percentage of patients requiring postoperative rescue analgesics was significantly higher in group C as compared with group A and group B ( P = 0.018 ) . CONCLUSION Local anesthesia with bupivacaine and intravenous parecoxib are both effective at decreasing postoperative pain and pethidine requirements after LC BACKGROUND Intraperitoneal local anesthesia ( IPLA ) during elective laparoscopic cholecystectomy ( el-LC ) decreases post-operative pain . None of the studies have explored the efficacy of IPLA at emergency laparoscopic cholecystectomy ( em-LC ) . A longer operative duration , the greater frequency of washing , and the inflammation associated with cholecystitis or pancreatitis are a few reasons why it can not be assumed that a benefit in pain scores will be seen in em-LC with IPLA . This study was undertaken to assess the efficacy of IPLA in patients undergoing em-LC . METHODS Double-blind r and omized sham controlled trial was conducted of 41 consecutive subjects undergoing em-LC . IPLA was delivered by a combination of injection to the diaphragmatic and topical wash over the liver and gallbladder with bupivacaine or saline . The primary outcome was visual analogue scale pain scores until discharge . Secondary outcomes included pain scores in theatre recovery and analgesic consumption . RESULTS One patient had a procedure converted to open and was excluded . There was no significant difference in pain scores in the ward or theatre recovery . Analgesic use , respiratory rate , oxygen saturation , duration to ambulation , eating , satisfaction scores , and time to discharge were comparable between the two groups . CONCLUSIONS IPLA during em-LC does not influence postoperative pain . Other modalities of analgesia should be explored for decreasing the interval between diagnosis of acute admission and em-LC AIM To investigate the effect of pain relief after infusion of ropivacaine at port sites at the end of surgery . METHODS From October 2006 to September 2007 , 72 patients undergoing laparoscopic cholecystectomy ( LC ) were r and omized into two groups of 36 patients . One group received ropivacaine infusion at the port sites at the end of LC and the other received normal saline . A visual analog scale was used to assess post 
    Output:
    
Conclusions : Parecoxib can substantially promote postoperative pain relief in patients with laparoscopic cholecystectomy