Postoperative Pain Relief Following Bupivacaine Injection in Sites & Intraperitoneal Spray of Laparoscopic Cholecystectomy

Background: Postoperative pain management is an important issue to increase the quality of laparoscopic procedures. In this study the effects of Bupivacaine injection in ports of laparoscopic cholecystectomy and adjunction site of liver and gall bladder was determined on postoperative pain and opioid administration.

Materials and Methods: In this randomized clinical trial, 100 patients who underwent elective laparoscopic cholecystectomy between 2013 and 2015 were enrolled in the study. The patients were randomly assigned to receive either intra-peritoneal spray of 15 ml of bupivacaine 0.25% solution over gall bladder bed and infiltration of bupivacaine 0.25% in port 1 to 3 incisions or normal saline in the same manner. The visual analogue scale was used to assess post-operative pain. Also administered opioid dose and side effects were registered and compared between two groups.

Results: In this study the pain levels of shoulder and ports sites were significantly less in Bupivacaine group compared to control group (P=0.001). Also the vomiting frequency was significantly lower in Bupivacaine group in first and sixth hours (P <0.05) but not after sixth hour (P > 0.05). Additionally the opioid use was significantly lower in intervention group (P < 0.05).

Conclusion: Bupivacaine injection in ports of laparoscopic cholecystectomy and adjunction site of liver and gall bladder is effective on postoperative pain and opioid consumption leading to less pain and lower opioid use.