2017, Cilt 9, Sayı 3, Sayfa(lar) 042-045
Pain management with local anaesthetic infiltration after laparoscopic cholecystectomy
Kağan Gökçe1, Manuk N. Manukyan2, Uğur Deveci2, M. Sertan Kapaklı2
1İstanbul Haydarpaşa Numune Eğitim ve araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye
2Maltepe Üniversitesi Tıp Fakültesi, Genel Cerrahi AD, İstanbul, Türkiye
Keywords: Pain management, bupivacaine , laparoscopic cholecystectomy

Aim: Laparoscopic cholecystectomy (LC) is the most frequently performed elective surgery for symptomatic cholelithiasis. Trocar site pain after LC causes increased stress, morbidity and hospital stay. Consumption of intravenous opioid and nonopioid analgesics for control of postoperative pain is common. Intravenous analgesics have also side effects. Pain control with local anaesthetic infiltration can reduce intravenous analgesics consumption and postoperative stress. The aim of this study is point the efficiencies of local anaesthetic infiltration after LC.

Methods: A total of 100 patients with ASA Class 1-2 were included to the study. All of the patients underwent to standard LC. Patients were divided into two groups of 50 each. Group-1 consisted of local bupivacaine enjected 50 patients and group-2 was consisted of non-local enjected 50 patients, after LC. Two groups were compared with the Mann-Whitney U test. A total of 10 cc sterile 1% bupivacaine infiltration was performed each patient in group-1. The 4th and 12th hour visual analogue scale (VAS) scores, were recorded. SPSS 15.0 program was used for statistical evaluation.

Results: In group-1, the mean VAS score was 2 in the fourth hour and 3.4 in the twelfth hour; in group-2 the fourth hour was 5.1 and the twelfth hour was 4.6. The mean VAS score in group-1 was statistically lower (p<0.02) than group-2.

Conclusion: Local anesthetic injection to trocar wounds is cheaper and safer than other anesthetic methods. Bupivacaine infiltration after LC is a feasible method, which reduces pain in trocar incisions and consumption of intravenous opioid and nonopioid analgesics.