Role of intraperitoneal instillation of bupivacaine after laparoscopic cholecystectomy for post-operative pain management: a randomized controlled trial


  • Pramatha Nath Datta Department of Surgery, KPC Medical College, Kolkata, West Bengal, India
  • Arijit Roy Department of Surgery, KPC Medical College, Kolkata, West Bengal, India



Peritonitis, Peritoneal lavage, Solutions, Normal saline, Infection


Background: Intra peritoneal (IP) local anaesthesia (LA) is a simple, cheap and safest method of providing post-operative (post-op) analgesia after laparoscopic cholecystectomy (LC). In this research, the role of intraperitoneal (IP) instillation of bupivacaine on post-op pain was studied. Post-op pain at 6, 12 and 24 hours was assessed using numeric rating scale. The degree of ambulation postoperatively at 6 and 24 hours and the requirement of analgesics was taken into account. The length of hospital stay was also a factor.

Methods: A total of 76 patients during January 2018 to December 2018, undergoing LC, fitting the inclusion criteria were included randomly and divided in to two groups, bupivacaine group (B) and control group (A) based on a pre-generated random number sequence by the principal investigator. The surgical outcome was compared based on multiple parameters and the primary outcome measures were the post-op pain and analgesic requirement.

Results: Degree of ambulation at 6 hours was significantly better in group B, compared to group A (p=0.008). The requirement of first dose of rescue analgesia was found to be within 6 hours (post-op) in 34 patients of group A (89.47%) as compared to 13 patients of group B (34.21%), was found to be statistically significant (p<0.001). There was statistically significant (p=0.002) difference with respect to length of hospital stay between the two groups.

Conclusions: In our study we found that IP bupivacaine (0.5%) is an effective, economical, safe method of post-op pain management with better post-op recovery. 

Author Biographies

Pramatha Nath Datta, Department of Surgery, KPC Medical College, Kolkata, West Bengal, India

Assisstant Professor,

Dept. Of Surgery 

Arijit Roy, Department of Surgery, KPC Medical College, Kolkata, West Bengal, India

Associate Professor,

Dept. Of Surgery 


Vecchio R, MacFayden BV, Palazzo F. History of laparoscopic surgery. Panminerva Med. 2000;42:87-90.

Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic Cholecystectomy The New'Gold Standard'?. Arch Surg. 1992;127(8):917-23.

Narchi P, Benhamou D, Fernandez H. Intraperitoneal local anaesthetic for shoulder pain after day-case laparoscopy. The Lancet. 1991;338(8782-8783):1569-70.

Chundrigar T, Hedges AR, Morris R, Stamatakis JD. Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy. Annals of the Royal College of Surgeons of England. 1993;75(6):437-9.

Gayatri P. Post-operative pain services. Indian J Anesth. 2005;49:17-9.

Patel PK, Dora SK, Pande B. Effect of intraperitoneal bupivacaine on postoperative pain in laparoscopic gynaecological surgery- a randomised controlled trial. J Evolution Med Dent Sci. 2018;7(10):1209-11.

Hollman A. Experience of LAC-43: a new anaesthesia with prolonged action in operative and therapeutic regional anaesthesia. Ann Chir Gynae Fen. 1966;55:322-6.

Watt MJ, Ross DM, Atkinson PS. A clinical trial of bupivacaine. Anaesthesia. 1968;23:2.

Tucker GT, Mather LE. Pharmacokinetics of local anaesthetic agents. Br J Anaesth. 1975;47:213.

Wilson EB, Bass CS, Abrameit W, Roberson R, Smith RW. Metoclopramide versus ondansetron in prophylaxis of nausea and vomiting for laparoscopic cholecystectomy. Am J Surg. 2001;181:138-41

Wall PD. The prevention of postoperative pain. Pain. 1988;33(3):289-90.

Chakravarty N, Singhai S, Shidhaye RV. Evaluation of intraperitoneal bupivacaine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: a prospective randomized trial. Anaesth Pain Intensive Care. 2014;18(4):361-6.

Neerja B, Vikas S, Pramila C.Intraperitoneal bupivacaine instillation for postoperative pain relief after laparoscopic cholecystectomy. Indian J Anaesth. 2002;46(1):49-52.






Original Research Articles