The Role of Local Infiltration of 0.25% Bupivacaine at the Port Sites in Patients with Laparoscopic Cholecystectomy to Control Early Post-Operative Pain

Abstract

Background: Pain management constitutes a vital aspect of surgical procedures, with analgesics commonly employed for this purpose. However, the use of analgesics can be associated with certain complications. This study aimed to assess the role of local infiltration of 0.25% bupivacaine at the port sites in patients with laparoscopic cholecystectomy to control early post-operative pain. Material & Methods: This cross-sectional study was carried out in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2022 to September 2022. As the study subjects, a total of 40 adult patients who underwent laparoscopic cholecystectomy for symptomatic gallstone disease enrolled purposively. Data were analyzed by using SPSS version 23.0 were applied. Results: In this study, group 1 had a mean NRS pain score of 2.55±0.6 at 6 hours and 4.1±1.21 at 12 hours, with the first analgesic given after 13.85±1.57 hours and a repeat dose after 22±2.29 hours. Group 2, however, had higher pain scores: 6.8±1.15 at 6 hours, and 7.95±0.6 at 12 hours, with the first analgesic administered after 2.75±0.72 hours, and a repeat dose after 9.5±1.15 hours. In group 1, 30.0% of patients required a single analgesic dose in the first 12 hours, with 75.0% needing a total of 2 doses. Only 5% required analgesics within the first 6 hours. In contrast, in group 2, nearly 90% needed analgesics within the first 12 hours, with all patients requiring analgesics within the first 6 hours. This difference was statistically significant (p<0.05). Conclusions: Local administration of 0.25% bupivacaine at the port sites following laparoscopic cholecystectomy appears to be more effective than conventional analgesics in reducing post-operative port site pain. Additionally, it reduces the dose and frequency of conventional analgesic consumption.