Port site infiltration of local anesthetic in reduction of post-operative pain after laparoscopic cholecystectomy

Abstract EN

Laparoscopic cholecystectomy has become a standard technique for gallbladder surgery of symptomatic cholelithiasis.

However, pain is the dominant complaint after this surgical procedure.

This study aimed to evaluate the efficacy of long acting local anesthetic (Bupivacaine), infiltrated at port sites in amelioration of pain following laparoscopic cholecystectomy.

Seventy two patients underwent elective laparoscopic cholecystectomy enrolled in this study, patients were divided into treatment and control groups of 36 patients each.

Following removal of the gallbladder, treatment group received 20 ml of 0.25 % Bupivacaine in divided doses at the trocar sites, unlike control group which receive no treatment.

The evaluation of postoperative pain was done at fixed time intervals by McGill Pain Questionnaire, and the dosage of narcotic analgesic Tramadol, was also recorded.

Mean pain scores at 6 hours postoperatively in treatment group was less than that of the control group (4.5 and 7.6) respectively with (p < 0.05).

Pain scores at 12 and 24 hours postoperatively did not differ between the two study groups (p > 0.05).

The mean total narcotic analgesic dose used during the first 24 hours postoperatively was less in the treatment group compared to the control group (92 mg and 158 mg) respectively with (p < 0.05).

The localization of pain during the first 24 hours postoperatively was 58 % incisional, 36 % intra-abdominal, and shoulder tip pain 6 %.

In conclusion, postoperative infiltration of long lasting local anesthetic (Bupivacaine) into the port sites of laparoscopic cholecystectomy may be desirable.

This is simple, inexpensive, and effective technique to minimize early postoperative pain which can be practiced for elective laparoscopic cholecystectomy.