Postoperative pain relief after laparoscopic cholecystectomy : intraperitoneal lidocaine versus nalbuphine

Abstract EN

Background Patients undergoing laparoscopic procedures do experience postoperative pain, especially in the abdomen, back, and shoulder region.

Intraperitoneal injections of a local anesthetic have been proposed to minimize postoperative pain after laparoscopic surgery.

Therefore, this prospective, randomized, controlled, placebo study was conducted to compare the effectiveness of intraperitoneal lidocaine with that of intraperitoneal nalbuphine for postoperative analgesia after laparoscopic cholecystectomy (LC) surgery.

Setting Assiut University Hospitals, postoperative surgical world, Egypt.

Patients and methods Eighty-one patients with ASA I or II undergoing LC were included in the study.

They were classified randomly into three groups: group C, which comprised 27 patients who were given 50 ml normal saline intraperitoneally; group L, which included 27 patients who were given 200 mg lidocaine intraperitoneally in 50 ml normal saline; and group N, which included 27 patients given 10 mg nalbuphine intraperitoneally in 50 ml normal saline.

Postoperative pain was recorded using the visual analogue scale for 24 h after LC.

Postoperative analgesic consumption was also recorded.

Results The mean visual analogue scale was significantly lower in both lidocaine and nalbuphine groups than in the control group within 24 h after surgery.

The incidence of shoulder pain was 29.6% in the control group, 22.2% in the nalbuphine group, and 14.8% in the lidocaine group.

The mean value of total analgesic consumption in the form of intravenous paracetamol was significantly lower in the lidocaine group (2.3 g ± 0.60) and nalbuphine group (2.5 g ± 0.63) when compared with control group C.

There were no significant differences between the three groups as regards hemodynamics.

Conclusion Although both lidocaine and nalbuphine when used intraperitoneally produce postoperative analgesia, intraperitoneal lidocaine gives a better analgesic profile with fewer unwanted effects.