Intra-Peritoneal Bupivacaine Instillation for Post-Operative Pain Relief after Laparoscopic Cholecystectomy: A Prospective Study

Abstract

Background Pain relief remains milestone achievement ascribed to laparoscopic cholecystectomy. Post laparoscopic cholecystectomy patient still complains of port site/incisional pain, shoulder pain and vague upper abdominal pain. A simple method of portal or incisional infiltration and intra-peritoneal spraying of a local anesthetic agent over gall bladder fossa can reduce postoperative pain. Method This study was conducted to determine whether Bupivacaine wash at gall bladder fossa and infiltration of local anesthetic at trocar sites has any effect in postoperative pain relief. This prospective study was conducted on 68 patients, where 20 ml of normal saline wash was given in group A and 20ml of 0.25% bupivacaine wash was given in group B at the gall bladder fossa and in both the groups, the same local anesthetic was infiltrated at the port sites and the outcomes was studied. Results Pulse rate and blood pressure were significantly low in group B than group A. The median pain score was significantly low in group B than group A. Also, the total number of analgesic doses used in group B was significantly less than the group A. Conclusions Instillation at gall bladder fossa and infiltration to the port sites using 0.25% bupivacaine is an effective method of postoperative pain relief after laparoscopic cholecystectomy.