Key result
Intraincisional infiltration of bupivacaine significantly reduced postoperative abdominal pain up to 12 hours compared to intraperitoneal infiltration and control in patients undergoing laparoscopic cholecystectomy.
Why the study?
The study aimed to compare the efficacy of local anaesthetic bupivacaine infiltration at the incision site versus intraperitoneally on postoperative pain following laparoscopic cholecystectomy.
Does intraincisional bupivacaine improve postoperative pain compared to intraperitoneal bupivacaine or control in patients undergoing laparoscopic cholecystectomy?
RCT (n=180)
Blind envelope system
No
Does intraincisional bupivacaine improve postoperative pain compared to intraperitoneal bupivacaine or control in patients undergoing laparoscopic cholecystectomy?
Absolute Event Rate: 1.4% vs 2.3%
p-value: p=<0.001
Intraincisional infiltration of bupivacaine is more effective than intraperitoneal infiltration for reducing postoperative abdominal pain and rescue analgesic requirements after laparoscopic cholecystectomy.
May support intraincisional bupivacaine for postoperative pain after laparoscopic cholecystectomy; leaves open need for randomized confirmation.
Background: The aim of this study was to compare the efficacy of infiltration of local anaesthetic bupivacaine at incision site (port site) and intraperitoneally on postoperative pain in patients undergoing laparoscopic cholecystectomy.Methods: This was a randomized controlled study carried out on patients undergoing laparoscopic cholecystectomy. The patients were divided into three groups of 60 patients each. Group 1 was the control group which did not receive either intraincisional or intraperitoneal bupivacaine. Group 2 received intraincisional bupivacaine 0.25% 20 ml, while group 3 received 20 ml solution of bupivacaine 0.25% 20 ml intraperitoneally. Postoperative pain was recorded for 24 hours post-operatively.Results: The incidence of abdominal pain was significantly lower in the group which received intraincisional bupivacaine upto 12 hours postoperatively. Right shoulder pain was low in group receiving intraperitoneal bupivacaine as compared to group 2, but it was not statistically significant.Conclusions: Intraincisional (port site) infiltration of bupivacaine is more effective than intraperitoneal infiltration for postoperative pain relief after laparoscopic cholecystectomy. It is easier to apply and there is less requirement of postoperative analgesics.
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Bacha et al. (2019) conducted an RCT in Symptomatic cholelithiasis (n=180). Intraincisional bupivacaine vs. Intraperitoneal bupivacaine or control was evaluated on Mean postoperative pain VAS score at 12 hours (p=<0.001). Intraincisional infiltration of bupivacaine significantly reduced postoperative abdominal pain up to 12 hours compared to intraperitoneal infiltration and control in patients undergoing laparoscopic cholecystectomy.
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