Intraperitoneal Bupivacaine in Laparoscopic Cholecystectomy, Efficacy and Feasibility

Abstract

Abstract Background Laparoscopic Cholecystectomy among the most frequently performed elective daycare surgeries. After laparoscopic cholecystectomy shoulder and abdominal pain causes considerable distress, to determine the efficacy of intraperitoneal bupivacaine instillation on management of early postoperative pain in patient undergoing laparoscopic cholecystectomy. Aim of the Work To determined the efficacy of intraperitoneal bupivacaine instillation on management early postoperative pain in patient with laparoscopic cholecystectomy. Patients and Methods This is a prospective randomized study with sample size of 50 patients underwent elective laparoscopic cholecystectomy. We recruited patients from surgery department at Agouza Hospital. We randomly assigned patients to undergo laparoscopic cholecystectomy with bupivacaine and 25 ml of physiological saline (0.9% normal saline) on liver bed or without bupivacaine. Results Fifty patients finally met our inclusion criteria. In bupivacaine group, mean age was 35 (± 6.6), 64% were females and 36% were males. While in non-bupivacaine group mean age was 37.6 (± 6.6), 68% were females and 32% were males with no statistically significant difference between both groups; age (P value=0.22) and age (P value=0.77), In bupivacaine group there was significant pain reduction compared to non-bupivacaine group in terms of VAS at 2 h (p value=0.04), 12 h (p value=0.02), 24 h (, p value=0.01) and VRS at 2 h (p value<0.01), 12 h (p value<0.01), 24 h (p value<0.01). Hospital stay was lower hospital stay in bupivacaine group 0.94 (± 0.16) than nonbupivacaine group 1.21 (± 0.41) (p value<0.01). Need for additional analgesia was lower in bupivacaine group (P value <0.01). Conclusion Intraperitoneal route for administration of local anaesthetic is a safe and effective approach. Bupivacaine is an effective treatment option to achieve postoperative analgesic, limit the duration of hospital stay and the need for additional analgesia. But it did not significantly lower the incidence of nausea and vomiting.