[New routes for infiltration: intraperitoneal injections]

Intraperitoneal administration of local anaesthetics is frequently used during gynaecological laparoscopy and especially after laparoscopic sterilization where the solution may be instilled, sprayed or infiltrated around the clip or the rings. In addition, the subdiaphragmatic instillation of local anaesthetics by the surgeon during laparoscopy is followed by a decrease in the intensity of postoperative scapular pain which is known to last 2-3 days and is due to some degree of residual pneumoperitoneum. After laparoscopic cholecystectomy, the analgesic effects of the administration of local anaesthetics via the intraperitoneal route remain controversial. The pharmacokinetic data available which confirm the safety of doses up to 100 mg of bupivacaine or 800 mg of lidocaine, should encourage the use of larger doses, especially after cholecystectomy.