Intraperitoneal Bupivacaine Does Not Effectively Reduce Pain After Laparoscopic Cholecystectomy: a Randomized, Placebo-controlled and Double-blind Study

The analgesic effect of intraperitoneal infusion of local anesthesia after laparoscopic cholecystectomy is controversial, and the reported results range from considerable pain reduction to no significant pain reduction. In this randomized, placebo-controlled and double-blind study, we examined the efficacy of intraperitoneal administration of bupivacaine at the end of surgery in 65 patients undergoing elective laparoscopic cholecystectomy. Pain score was assessed using a visual analog scale 2 hours, 4 hours, 8 hours, 24 hours, and 48 hours after surgery. The peak expiratory flow was evaluated preoperatively and 2 hours, 4 hours, 8 hours, and 24 hours after surgery. The daily analgesic consumption was recorded. The authors only detected an analgesic effect in the heavier (body weight >77 kg) subgroup of patients at 2 hours, but detected no significant improvement of the peak expiratory flow, no decrease in the analgesic medication requirement, and no influence on the duration of hospital stay.