Laparoscopic cholecystectomy; randomized, controlled trial of bupivacaine injection to decrease pain

ABSTRACT

To determine if intraoperative instillation of bupivacaine into gall bladder fossa would decrease early postoperative pain after laparoscopic cholecystectomy, Double-blind, randomized, controlled trial. Surgical Unit-l, Holy Family Hospital, Rawalpindi and Surgical Unit-1, Benazir Bhutto Hospital, Two year study. Fifty patients underwent laparoscopic cholecystectomy group-A. They were compared with a control group of fifty patients who had laparoscopic cholecystectomy but did not receive bupivacaine Group-B. Instillation of 10 ml of 0.5% bupivacaine into gall bladder fossa intra operatively after removal of gall bladder. Visual analogue scale [VAS] pain scores assessed 3 times post operatively, at 1, 6 and 24 hours, using similar peroperative and postoperative analgesics in both groups. Mean VAS pain scores [range 0 [no pain] to 10 [severe pain]] at 1 hour and at 6 hours after surgery were 6.5 and 4.2 respectively, in the bupivacaine group [Group-A] compared with 6.2 and 4.5 respectively, in the control group [Group-B] [p =.085 and 0.078,sd=.919 and.495]. VAS scores at 24 hours postoperatively did not differ between the two groups [2.4 VS 2.5][p=.282,sd=.636]. Instillation of bupivacaine into gall bladder fossa has no effect on post operative pain control in elective laparoscopic cholecystectomy