Intraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomy

Abstract

Background: The effects of intraperitoneal administration of bupivacaine on pain after laparoscopic cholecystectomy were studied in a prospective, double-blind, randomised trial.

Methods: Eighty ASA 1 and 2 patients were randomly assigned to one of two groups. Immediately after pneumoperitoneum was obtained patients in group 1 were given 15 ml of 0.5% bupivacaine injected under direct vision into the hepato-diaphragmatic space, near and above the hepato-duodenal ligament and above the gallbladder. At the end of operation another 15 ml of bupivacaine was injected. Patients in group 2 were given 15 ml of 0.9% saline solution in a similar fashion. Postoperative pain was assessed using a visual analogue scale (VAS 100 mm) at 0.5, 4, 8, 12 and 24 h after surgery. Analgesic consumption was also recorded.

Results: Patients' data were similar in the two groups. Pain was more intense in the saline group at each time point. Significant differences between the groups were present for up to 8 h. Analgesic consumption was significantly lower in the bupivacaine group. No side-effects occurred.

Conclusion: We conclude that reducing pain with intraperitoneal bupivacaine is effective, easy to administer, and without side-effects.