Evaluation of the effect of periportal infiltration of ropivacaine in laparoscopic cholecystectomy patients: a randomized double-blind, placebo-controlled study in a tertiary-care teaching hospital

Abstract

Background: Pain after laparoscopic cholecystectomy (LC) is very common and has multifactorial origin. Traditionally, several methods including postoperative nonsteroidal anti-inflammatory drugs (NSAIDS), opioids, and opioid derivatives have been used to counter the earlier mentioned complications. However, procedures such as peritoneal infiltration and preincisional port-site infiltration of long-acting local anesthetics have reduced the requirement of postoperative analgesia and reduced the incidence of drug-induced nausea and vomiting. Objective: To evaluate the effect of periportal infiltration of ropivacaine in patients who underwent LC. Materials and Methods: A total of 100 patients undergoing LC were randomly divided into two groups: group I (n = 50) patients were infiltrated with port-site long-acting local anesthetic ropivacaine and group II (n = 50) patients were infiltrated with normal saline (matching placebo). In the postoperative period, both groups were compared with regard to severity of pain using visual analog scale (VAS), analgesic requirement, and incidence of nausea and vomiting. Result: Male-to-female ratio, mean age, weight, duration of surgery, and duration between extubation and first analgesic dose in groups I and II were 1:9 and 1:6.16, 37.12 ± 7.80 and 39.82 ± 9.88 years (p = >0.05), 60.76 ± 3.94 and 61.88 ± 4.94 kg (p > 0.05), 60.10 ± 15.90 and 61.90 ± 18.94 min (p = >0.05), and 438.90 ± 190.80 and 184.40 ± 46.27 min (p = 0.05). Conclusion: Preincisional port-site infiltration of ropivacaine reduced the postoperative pain; no significant change in the incidence of shoulder pain was noticed. Significant reduction was observed in requirement of NSAIDs and opioids in ropivacaine group, which also reduced the drug-induced nausea and vomiting.