Use of subdiaphragmatic bupivacaine instillation to control postoperative pain after laparoscopic surgery

Although postoperative pain has been reduced significantly since the advent of laparoscopic surgery, many patients still complain of moderate abdominal and shoulder pain during the first 48 to 72 h after surgery. In this study, the effect of subdiaphragmatic instillation of bupivacaine after laparoscopic cholecystectomy was investigated. The evaluation of postoperative pain was done according to a numerical verbal scale and the dose of analgesia required. The results showed a considerable reduction of postoperative pain during the first 48 h after surgery in patients who received bupivacaine instillation. Although the literature shows certain controversy as to the effects of similar methods, our study concludes that instillation of a long-acting anesthetic, such as bupivacaine, into the subdiaphragmatic space after laparoscopic procedures is effective in postoperative pain reduction.