Prophylaxis of postoperative pain by intraperitoneal instillation of 0.5 bupivacaine after laparoscopic cholecystectomy

Abstract

Background. The purpose of this randomized double blind and prospective study was to evaluate the postoperative analgesic efficacy of bupivacaine 0.5% instillated intraperitoneally after laparoscopic cholecystectomy.

Methods. 39 patients ASAI/II were assigned into two groups: a control group C (n=20) in which 100ml saline solution (placebo) was administered and group B (n=19) in which 100 mg bupivacaine 0.5% was instillated subdiaphragmatically intraperitoneally All patients received a general anaesthesia with isoflurane.
We evaluated postoperative abdominal pain and shoulder pain, the postoperative respiratory function (PEF), and the incidence of vomiting.

Results. The intraperitoneally instillation of 100 mg bupivacaine 0.5% did not reduce pain and incidence of vomiting after laparoscopic cholecystectomy, but significantly reduced the PEF at 6 hours postoperatively.

Conclusions. The results of this study suggest that the administration of bupivacaine 0.5% subdiaphragmatically does not provide significant analgesic benefit nor reduction of the incidence of vomiting. Since side effects on pulmonary function occurred, we do not recommend intraperitoneal local anesthetic pain therapy after laparoscopic cholecystectomy.

Key words: laparoscopic surgery, bupivacaine 0.5% instillation, postoperative shoulder pain.

Jurnalul Român de Anestezie Terapie intensivă 2003 Vol.10 Nr.2, 115-119

Prevenirea durerii postoperatorii după colecistectomia laparoscopică prin instilarea intraperitoneală de bupivacaină 0,5%