Intraperitoneal Bupivacaine as Post-laparoscopic Cholecystectomy Analgesia

Area of Science:

• Anesthesiology
• Surgical Pain Management
• Pharmacology

Background:

• Post-laparoscopic cholecystectomy pain management remains a challenge.
• Effective analgesia is crucial for patient recovery and satisfaction.
• Exploring novel methods for pain control is essential.

Purpose of the Study:

• To evaluate the effectiveness of large-volume, diluted intraperitoneal bupivacaine for post-laparoscopic cholecystectomy pain relief.
• To compare pain-free duration and analgesic requirements between bupivacaine and saline groups.

Main Methods:

• A randomized controlled trial involving 110 patients undergoing laparoscopic cholecystectomy.
• Group A received 500 ml normal saline, while Group B received 20 ml 0.5% bupivacaine diluted in 480 ml normal saline for intraperitoneal irrigation.
• Pain-free duration, Numerical Rating Scale (NRS) scores, and total analgesic consumption were assessed.

Main Results:

• Patients receiving intraperitoneal bupivacaine had a significantly longer pain-free duration (16.53 ± 2.65 hours) compared to the saline group (0.99 ± 0.51 hours) (p<0.001).
• The bupivacaine group required significantly less tramadol (31.00 ± 14.98 mg) versus the saline group (124.80 ± 26.68 mg) (p<0.001).
• NRS scores differed significantly at multiple postoperative intervals, favoring the bupivacaine group.

Conclusions:

• Intraperitoneal administration of large volumes of diluted bupivacaine is an effective method for prolonged pain relief after laparoscopic cholecystectomy.
• This technique offers a promising approach to reduce postoperative opioid requirements and improve patient comfort.