Port Site Infiltration of Local Anaesthetic For Post-operative Analgesia After Laparoscopic Cholecystectomy

Abstract Laparoscopic cholecystectomy has become the most common surgical procedure for symptomatic gallstone diseases. However, postoperative pain is the only patient complaint that delays the discharge. Although pain after laparoscopic cholecystectomy is less intense than after open cholecystectomy, some patients still experience considerable discomfort during the first 24 to 72 hours following surgery. This study aimed to evaluate the efficacy of long acting local anaesthetic (Bupivacaine) infiltration into port site to reduce postoperative pain following laparoscopic cholecystectomy. Sixty two patients underwent elective laparoscopic cholecystectomy enrolled in this study, patients were divided into treatment and control groups of 31 patients each. Following removal of the gallbladder, treatment group received 20 ml of 0.5% Bupivacaine at the four port sites, unlike control group which receive no treatment. The evaluation of postoperative pain was done at 4, 8, 12 and 24 hours postoperatively by using Visual Analogue Scale (VAS) and the dose of Non Steroidal Anti-inflammatory Drug (NSAID) was also recorded, Mean VAS score at 4, 8 and 12 hours postoperatively in experimental group was less than that of the control group (p<0.05). VAS score at 24 hours postoperatively did not differ berween two study groups (p>0.05). The mean totul NSAID doses used during first 24 hours postoperatively was less in the experimental group than control group (p<0.05). The localization of pain during first 24 hours. postoperatively was 60% incisional, 30% intra abdominal and shoulder tip pain 10%. Port site infiltration of bupivacaine following laparoscopic cholecystectomy reduce postoperative pain and this simple, inexpensive and effective method should be practiced to minimize early postoperative pain for all elective laparoscopic cholecystectomy.