Intraperitoneal Bupivacaine for Postoperative Pain Relief After Laparoscopic Cholecystectomy

Abstract

Laparoscopic technique has become the gold standard for cholecystectomy in the past decade. Most patients are being discharged the same day as surgery or on the first postoperative day [1,2]. One important benefit of laparoscopic surgery generally is reduced postoperative incisional pain, whereas in open surgery the pain and discomfort from a large abdominal wall incision may be severe enough to prevent early discharge [3]. However, in laparoscopic cholecystectomy (LC) pain, nausea, and vomiting stemming from visceral manipulation may be severe enough to prevent early discharge. Peripheral use of local anesthetics for postoperative pain relief has become a popular practice in many minor surgical procedures and in laparoscopic procedures as well [4,5]. Although there is limited experience with use of lidocaine, mepivacaine, and ropivacaine, with its relatively potent anesthesia and longer duration of action, up to 6 hours, bupivacaine has become popular recently [6–10]. Nevertheless, intraperitoneal use of local anesthetics, especially bupivacaine for pain relief after LC, is still controversial [5–10]. After the approval of the project by the Institutional Review Board of Surgery Department of Ankara University Medical School and with the informed consent of the patients, 50 adult elective LC patients were randomly allocated into two groups by envelopes. The inclusion criteria were, American Society of Anesthesiologists (ASA) I-II uncomplicated patients with symptomatic gall stone disease, who did not have a history of diabetes mellitus, prior abdominal surgery, …