title: Effectiveness of Local Anesthetics in Laparoscopic Cholecystectomy: A Randomized Clinical Trial.
abstract: BACKGROUND
  Laparoscopic cholecystectomy is the gold standard for gallstone disease. Postoperative pain still is considerable and may prevent early discharge.
  
  
  METHODS
  A randomized controlled blind clinical trial was designed for all patients undergoing laparoscopic cholecystectomy. The groups were control (group A), preincisional trocar wound infiltration with bupivacaine (group B), and preincisional trocar wound infiltration and intraperitoneal instillation of bupivacaine over the gallbladder and liver surface before starting the dissection (group C). The operative technique and postoperative analgesia were standardized. The pain in 6 hours was assessed with the visual analog scale as the primary outcome.
  
  
  RESULTS
  The visual analog pain scores in the intraperitoneal bupivacaine were similar to the trocar wound infiltration alone and both were lower than the control group (P=0.05616).
  
  
  CONCLUSIONS
  Intraperitoneal application of local anesthetics and trocar wound infiltration did not lower the pain scores in comparison with trocar wound infiltration in our study.
authors.affiliation: *Department of General Surgery, 10a Enfermaria - Santa Casa de Misericórdia de Porto Alegre †Medical School, Santa Cruz do Sul University, RS, Brazil.
authors.forename: Marcelo M
authors.initials: MM
authors.lastname: Souto
authors.forename: Eloisa
authors.initials: E
authors.lastname: Radaelli
authors.forename: Andiara E
authors.initials: AE
authors.lastname: Giordani
authors.forename: Analuíza
authors.initials: A
authors.lastname: Savaris
authors.forename: Guilherme F
authors.initials: GF
authors.lastname: Bassols
mesh_terms: D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine