PORT SITE INFILTRATION OF LOCAL ANESTHETIC IN REDUCTION LAPAROSCOPIC CHOLECYSTECTOMY
Ali Kadhim Nazir & Issam Merdan
*MB,ChB, FICMS General Surgeon, Al-Sadder Teaching Hospital, Basrah, Iraq.
Professor of Surgery, Department of Surgery, Basrah College of Medicine, Basrah University, Iraq.
Laparoscopic cholecystectomy has become a standard technique for gallbladder surgery of symptomatic cholelithiasis. However, pain is the dominant complaint after this surgical procedure.
This study aimed to evaluate the efficacy of long acting local anesthetic (Bupivacaine), infiltrated at port sites in amelioration of pain following laparoscopic cholecystectomy.
Seventy two patients underwent elective laparoscopic cholecystectomy enrolled in this study, patients were divided into treatment and control groups of 36 patients each. Following removal of
the gallbladder, treatment group received 20 ml of 0.25% Bupivacaine in divided doses at the trocar sites, unlike control group which receive no treatment. The evaluation of postoperative pain
was done at fixed time intervals by McGill Pain Questionnaire, and the dosage of narcotic analgesic Tramadol, was also recorded.
Mean pain scores at 6 hours postoperatively in treatment group was less than that of the control group (4.5 and 7.6) respectively with (p<0.05). Pain scores at 12 and 24 hours postoperatively did
not differ between the two study groups (p>0.05). The mean total narcotic analgesic dose used during the first 24 hours postoperatively was less in the treatment group compared to the control
group (92 mg and 158 mg) respectively with (p<0.05). The localization of pain during the first 24 hours postoperatively was 58% incisional, 36% intra-abdominal, and shoulder tip pain 6%.
In conclusion, postoperative infiltration of long lasting local anesthetic (Bupivacaine) into the port sites of laparoscopic cholecystectomy may be desirable. This is simple, inexpensive, and effective
technique to minimize early postoperative pain which can be practiced for elective laparoscopic cholecystectomy.