title: Intraperitoneal lignocaine (lidocaine) versus bupivacaine after laparoscopic cholecystectomy: results of a randomized controlled trial.
abstract: BACKGROUND
  Intraperitoneal local anesthetics have been shown to improve postoperative pain after laparoscopic cholecystectomy (LC). However, the choice of local anesthetic agent is debatable. We compared the analgesic efficacy of intraperitoneal lignocaine (lidocaine) versus bupivacaine after elective LC.
  
  
  METHODS
  We conducted a double-blind, randomized, controlled trial. We randomized consecutive patients undergoing LC into two groups. Group L received 10 mL 2% lignocaine (lidocaine), whereas Group B received 10 mL 0.5% bupivacaine, each diluted in 10 mL normal saline. All patients underwent standard perioperative anesthesia and analgesia protocol. We assessed patients at 0, 4, 8, 12, and 24 h postoperatively for pain using the visual analogue scale and verbal rating scale, and the need for additional analgesic medications.
  
  
  RESULTS
  We analyzed a total of 206 patients: 106 in Group L and 100 in Group B. Demographic details were similar between groups (P > 0.05). Abdominal pain decreased significantly with time in both groups, with a similar mean response profile (P < 0.001). There was no statistically significant difference between groups with regard to abdominal or shoulder pain by both visual analogue scale and verbal rating scale at all five time intervals (P > 0.05). There was also no significant difference in the side effect profile of both drugs (P > 0.05). A lower proportion of patients in Group B required additional narcotic analgesia (87%) compared with Group L (94%). This difference was marginally significant (P = 0.057).
  
  
  CONCLUSIONS
  Bupivacaine and lignocaine (lidocaine) are both safe and equally effective at decreasing postoperative pain after LC.
authors: Department of Surgery, Aga Khan University, Karachi, Pakistan. doctormrkhan@yahoo.com
authors: Muhammad Rizwan
authors: MR
authors: Khan
authors: Rushna
authors: R
authors: Raza
authors: Syed Nabeel
authors: SN
authors: Zafar
authors: Faisal
authors: F
authors: Shamim
authors: Syed Ahsan
authors: SA
authors: Raza
authors: Khawaja Muhammad Inam
authors: KM
authors: Pal
authors: Hasnain
authors: H
authors: Zafar
authors: Rehman
authors: R
authors: Alvi
authors: Tabish
authors: T
authors: Chawla
authors: Rizwan
authors: R
authors: Azmi
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000009:adverse effects / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D008012:Lidocaine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine