Randomized controlled study of effectiveness and timings of bupivacaine at port site in managing pain after laparoscopic cholecystectomy

Rana Ranjit Singh; Darpan Bansal; Manbachan Singh; Avreen Singh Shah

doi:10.18203/2349-2902.isj20162888

Authors

Rana Ranjit Singh Department of surgery, SGRDIMSR, Vallah, Amritsar, Punjab,India
Darpan Bansal Department of surgery, SGRDIMSR, Vallah, Amritsar, Punjab,India
Manbachan Singh Department of surgery, SGRDIMSR, Vallah, Amritsar, Punjab,India
Avreen Singh Shah Department of surgery, SGRDIMSR, Vallah, Amritsar, Punjab,India

DOI:

https://doi.org/10.18203/2349-2902.isj20162888

Keywords:

Bupivacaine, Laparoscopic cholecystectomy, Postop pain, Port site

Abstract

Background: Laparoscopic cholecystectomy now a day is considered a day care procedure, but postoperative pain, requiring injectable analgesics is one of the hurdles in performing it as day care. Aim was to assess the effectiveness of port site instillation of bupivacaine in reduction of post-operative pain after laparoscopic cholecystectomy.

Methods: The study was conducted from November 2013 to November 2015 on 120 patients undergoing elective laparoscopic cholecystectomy at SGRDIMSAR, Sri Amritsar. The study was a randomized controlled in which patients were randomly allocated into 3 groups of 40 patients each. In group 1, pre-incisional local infiltration of the port sites with bupivacaine was done throughout all the layers of the abdominal wall. In group 2, local infiltration of the port sites with bupivacaine was done after the completion of surgical procedure and before the closure of skin. In Group 3 no local infiltration was done. The study was evaluated using Visual analog scale for a period of 24 hours post operatively.

Results: Instillation of bupivacaine at the port sites in laparoscopic cholecystectomy irrespective of the timing of instillation is an effective method of achieving pain control in the post-operative period as long as 24 hours after surgery.

Conclusions: Instillation of bupivacaine at the port sites in laparoscopic cholecystectomy is simple, safe, and without adverse effects and local anesthetics should be considered for instillation in all patients at the beginning and at the end of laparoscopic procedures.

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