Comparison of intraperitoneal instillation of Bupivacaine vs Normal Saline for postoperative pain relief after laparoscopic cholecystectomy.

Abstract

Objective: To evaluate whether local irrigation of Bupivacaine reduces post-operative pain after cholecystectomy. Study Design: Prospective, Randomized Controlled Trial. Setting: Department of Surgery, Government Teaching Hospital, Shahdara Lahore. Period: June 2020 to December 2022. Methods: For this study, 86 participants were divided into two groups, each containing 43 participants (Bupivacaine vs. no Bupivacaine). The control group (Group A) received an infiltration of 15 ml of 0.5% bupivacaine in the sub-diaphragmatic region on the right side and at port sites, while normal saline was administered to Group B. The Visual Analogue Pain Score Scale was employed to assess pain levels at 0-3, 3-5, 5-7, and above 7-10 hours post-surgery (VAS). Results: In this study, the total number of included individuals was 86. Moreover, the overall mean and median ages in months for both groups were 47.7 ± 8.97 and 47 (18-60) respectively, with the majority of patients being male (59 individuals, 68.6%). Furthermore, there was a statistically significant mean difference in pain scores on the visual analogue scale at 0–3 hours, 3–5 hours, 5–7 hours, and 7–10 hours (p-value < 0.05). Similarly, there was a statistically significant mean difference in pain scores on the visual analogue scale after more than three to five hours, more than seven hours, and more than ten hours (p-value < 0.05). Conclusion: Consequently, we inferred that intraperitoneal and local infiltration of Bupivacaine following laparoscopic cholecystectomy significantly reduced the level of postoperative discomfort and the requirement for analgesics.