Effect of intraperitoneal bupivacaine on postoperative pain following laparoscopic pelvic surgery

Background There is much debate on the effectiveness of intraperitoneal local anaesthetic instillation, during laparoscopic surgical procedures, as a means of relieving postoperative pain and reducing analgesia use. Study design Randomized, double‐blind, placebo‐controlled clinical trial. Setting Department of Obstetrics and Gynaecology, Mansoura University Hospital. Material and methods A group of 120 patients, admitted for elective laparoscopic pelvic surgery, were randomly allocated to two study arms: study group patients (n = 60) received instillation with 20 ml 0.5% bupivacaine intraperitoneally, before and at the end of the laparoscopic procedures, and placebo group patients (n = 60) patients received instillation with 20 ml 0.9% saline. Pain was evaluated by means of a visual analogue scale (VAS) at 0, 4, 8, 12 and 24 h postoperatively. The need for postoperative analgesia was also recorded. Results Pain scores and analgesia use were lower in the bupivacaine (study) group than in the saline (placebo) group. This difference was statistically significant (P < 0.05). Conclusion Topical instillation of 0.5% bupivacaine during laparoscopic gynaecological surgery reduces postoperative pain and analgesia use compared with that in a placebo group.