Effect of Intraperitoneal Instillation of Bupivacaine on the Pain Scores post operation of Laparoscopic Cholecystectomy

Abstract

Laparoscopic cholecystectomy is now an established form of treatment for patients with symptomatic gall stones as it is an excellent mean to minimize the trauma and agony of the patient following surgery, although recent studies have shown that patients still experience considerable pain after this surgery. In our current study, we aim to assess the effectiveness of intraperitoneal instillation of bupivacaine in the reduction of post-operative pain after laparoscopic cholecystectomy. 40 patients were randomly allocated in two groups; a study group that received 50 ml of bupivacaine (50%) instilled intraperitoneally into the gall bladder bed and under the surface of diaphragm, and control group which received 50 ml of 0.9% normal saline instilled in the same way. Data recorded from patients in pre-designed format and enrolled in a randomized double-blind prospective study showed a significant decline in post-operative pain scores in the study group between 1st and 4th hours as compared to the control group and, consequently, consumption of analgesics was lower in intergroup comparison. Discharge after surgery was significantly earlier in the study group (75%) one-day admission, while only (35%) of group B discharged after one-day hospitalization. We conclude that routinely intraperitoneal instillation of bupivacaine in laparoscopic cholecystectomy is a simple and safe method to minimize postoperative abdominal pain and analgesic requirements, which enhances early mobilization and discharge, and may become a routine practice.