EFFICACY OF INTRA PERITONEAL AND PORT SITES ADMINISTRATION OF BUPIVACAINE ON POSTOPERATIVE PAIN FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY ? A RANDOMIZED CLINICAL TRIAL

Background: Effective control of postoperative pain reduces the postsurgical discomfort and facilitates early ambulation. We evaluated the efficacy of trocar sites and intra peritoneal administration of bupivacaine in reducing the postoperative pain and analgesic requirement. Materials and methods: Sixty adult ASA physical status Ι to ΙΙΙ patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either, 30 ml of 0.25% bupivacaine at gall bladder bed plus 20 ml of 0.25 % bupivacaine at trocar sites (Group B) or an equal volume of normal saline (Group S). Postoperative pain was assessed using 10 point Visual analogue scale every four hours for 12 hours. The total analgesic consumption in 12 hours was also assessed. Results: The mean pain total pain score were significantly less (< 0.0001 ) in Group B (2.03±0.9289) when compared to Group S (4.266±0.4767). Total tramadol consumption decreased by 56% in Group B (113.33 ± 34.57mg) compared to Group S (256.66 ± 50.4 mg).The variation was statistically significant(p < 0.0001). Total consumption of diclofenac was significantly (p < 0.0001) less in Group B than Group S (7.5±22.884 Vs 55±33.733mg). Conclusion: Local anaesthetic administration is an effective component of multimodal analgesia for reducing postoperative pain and opioid requirement after laparoscopic cholecystectomy.