A comparative study of the effect of port-site local anaesthetic application and standard analgesics on postoperative pain management in laparoscopic cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy is the gold standard for treating patients with cholelithiasis. It is a minimally invasive technique that reduces surgical trauma with small and more cosmetic incisions, reduces blood loss and is associated with fewer postoperative complications and decreased length of hospital stay. The study was done to evaluate the efficacy of the local anaesthetic infiltrated at the port sites in laparoscopic cholecystectomy, in reducing postoperative pain. Methods: In the period from July to December 2023, fifty patients who underwent laparoscopic cholecystectomy at Sardar Vallabhbhai Patel Institute of Medical Sciences and Research, Ahmedabad were included in this prospective comparative study. Cases were divided into two groups. Patients who received bupivacaine at the port site were put in the local anaesthetic group and patients who received postoperative analgesia with NSAIDs/Opioids were put into the Standard Analgesia Group. Pain was measured by the Visual Analog Scale in all patients at the 1st, 6th, 12th, and 24th hour postoperatively. Results: A Significant reduction in pain intensity was detected in the Bupivacaine Group compared to the patients in Standard Analgesia Group at 1st and 6th hour. On other hand, there was no difference in pain intensity at the 12th and 24th hour. There was delay in the time and total doses of rescue analgesia in the local anaesthetic group. Conclusion: Applying local anaesthetic to the port sites after laparoscopic cholecystectomy significantly reduces postoperative pain intensity in the first 6 hours and delays the need for rescue analgesia, suggesting potential decrease in analgesic drug usage for postoperative pain management.