Pain relief after laparoscopic cholecystectomy. comparative study

ABSTRACT

The aim of this study was to determine whether subcutaneous injection of a long-acting local anesthetic at the site of ports of entry or installation of the same drug in the right subdiaphragmatic region would reduce post operative pain or not. The study was conducted on 60 patients who underwent laparoscopic cholecystectomy at King Hussein Medical Center [KHMC] between July 1995 and February 1996.Two scores of pain [visual pain scale and verbal rating scale] were used and assessment was done at two-hour intervals. Those patients were randomly allocated into three groups, group I received 20ml of 0.25% bupivacaine, intraperitoneally in the right subdiaphragmatic area, with the patient in the supine position. Group II received a total of 20 ml of 0.25% bupivacaine injected subcutaneously around the four port sites. Group III received saline with no local anesthetic. There was no significant reduction in the median visual scale or the verbal pain score among the three groups post-operatively. Subcutaneous infiltration with bupivacaine after laparoscopic cholecystectomy or its intraperitoneal instillation has no significant effect in relieving post-operative pain