Analgesic effect of intraperitoneal instillation of bupivacaine for postoperative laparoscopic cholecystectomy.
OBJECTIVE
To study the effectiveness of intraperitoneal instillation of bupivacaine for postoperative laparoscopic cholecystectomy pain relief, especially specific pain (visceral pain, shoulder pain and epigastric pain).


METHODS
Eighty ASA (American Society of Anesthesiologists) 1 and 2 patients were randomly assigned to receive either 20 ml of 0.5 per cent bupivacaine (n=39) or the same volume of saline (n=41) instilled under direct vision into the hepatodiaphragmatic space, near and above the hepatoduodenal ligament and above the gall bladder bed at the end of surgery. The intensity of visceral pain, shoulder pain and epigastric pain was assessed at 1, 6, 24 and 48 h after surgery using a visual analogue scale (100 mm VAS) and verbal rating "Prince Henry" pain scale (VRS). The time when analgesia was first required and total analgesic consumption were also recorded. t-test, Chi-square, Mann-Whitney U test and Kaplan-Meier survival analysis were used for statistical analysis.


RESULTS
Patient data were similar in the two groups except for body weight. There were no statistical differences between the two groups for the time when analgesia was first' required, VAS, VRS and total analgesic consumption.


CONCLUSIONS
In this study, intraperitoneal instillation of bupivacaine does not show any advantage for postoperative analgesia after laparoscopic cholecystectomy.
Jiranantarat
Vorakran
V
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Rushatamukayanunt
Winchai
W
Lert-akyamanee
Narong
N
Sirijearanai
Rattapol
R
Piromrat
Isariya
I
Suwannanonda
Pudsadee
P
Muangkasem
Jarinya
J
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D018709:Statistics, Nonparametric
D000779:Anesthetics, Local; D002045:Bupivacaine