Postoperative pain and nausea after laparoscopic cholecystectomy

Area of Science:

• Surgical Anesthesiology
• Gastrointestinal Surgery

Background:

• Laparoscopic cholecystectomy has reduced postoperative discomfort.
• Postoperative pain and nausea remain challenges impacting patient recovery and discharge.

Purpose of the Study:

• To assess the effectiveness of bupivacaine infiltration at trocar sites and ondansetron administration on postoperative pain and nausea.
• To evaluate the impact of these interventions on the need for opioid analgesics and patient-reported symptoms.

Main Methods:

• Prospective study involving laparoscopic cholecystectomy patients.
• Trocar sites infiltrated with bupivacaine during surgery.
• Single dose of ondansetron administered at the end of the operation.

Main Results:

• Significant reduction in postoperative pain, with 20% of patients not requiring postoperative opioids.
• 88% of patients did not require opioids after recovery room discharge.
• Effective control of postoperative nausea and vomiting, with two-thirds experiencing no nausea and most others reporting mild, transient symptoms.

Conclusions:

• Infiltration of stab-wound sites with local anesthetics (bupivacaine) is recommended.
• Administration of antiemetics (ondansetron) at the end of surgery effectively reduces postoperative nausea and vomiting.
• These combined strategies enhance patient comfort and potentially facilitate earlier discharge.