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 hy-pothesis that a reduction in the number of incisions may result in lower postoperative pain. On the other hand, some authors be-lieve that the SILC increases postoperative pain because of the ad-ditional stress on the port incision necessary to allow triangula-tion 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 sin-gle-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 prein-cisional 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 sur-gery as well