Role of Local Anesthetic Infiltration of Port Sites in Laparoscopic Cholecystectomy in Reducing Postoperative Pain and Opioid Consumption
Gamal Fouad Saleh Zaki, Asmaa Abobakr AbdAllah Mohamed, Mona Ahmed Ammar- General Medicine
Abstract
Background
Laparoscopic cholecystectomy is the gold standard for treating patients with cholelithiasis. It is a minimally invasive technique that reduces surgical trauma with small and more cosmetic incision, reduces blood loss and is associated usually with fewer postoperative complications and decreased length of hospital stay.
Aim of the Work
The aim of this study was to evaluate the efficacy of the long acting local anesthetic (bupivacaine) infiltrated at the port sites in laparoscopic cholecystectomy, in reducing postoperative pain and opioid consumption.
Patients and Methods
In the period from March 2021 to September 2021 fifty patients who underwent laparoscopic cholecystectomy were randomly allocated to one of two groups and comparative study was done. In the bupivacaine group (A), after skin preparation and before port insertion, 20 ml of 0.25% bupivacaine solution was infiltrated through the abdominal wall 4 ml around each port site. Postoperatively, pain score using VAS score, time of rescue analgesic and total rescue analgesic dose was calculated.
Results
The results showed that there a decrease in pain intensity in the bupivacaine group compared to control group with a significant difference, and there was delay in the time of rescue analgesia and total doses of rescue analgesia the bupivacaine group compared to control group with a statistically significant difference.
Conclusion
Port- site infiltration of bupivacaine in laparoscopic cholecystectomy successfully decrease post-operative pain during first 6 hour and delayed the time of rescue analgesia.