The Effect of Port-Site Local Anesthetic Application and Standard Analgesics on Postoperative Pain Management in Laparoscopic Cholecystectomy: A Prospective, Comparative Study

Abstract

Objective: We aimed to investigate the effects of bupivacaine applied to the port sites after laparoscopic cholecystectomy (LC) on postoperative pain (POP) intensity. Methods: The study included 188 patients who underwent LC under elective conditions for symptomatic cholelithiasis. Patients: 93 patients who received bupivacaine instead of the port were divided into the bupivacaine group, and 95 patients who received postoperative analgesia with nonsteroidal anti-inflammatory/tramadol drugs were divided into the Standard Analgesia Group. Pain was measured by the Visual Analog Scale (VAS) in all patients at the 1st, 6th, 12th, and 24th h postoperatively. All analgesic drugs administered to the patients were recorded. Results: There was no difference between the two groups in terms of demographic characteristics, duration of surgery, or hospitalization. The mean VAS score at 1st, 6th, 12th, and 24th h was 3.6, 4.4, 2.1, and 1.9 in the Bupivacaine Group, while it was 7.6, 6.9, 2.3, and 2.1 in the Standard Analgesia Group. A statistically significant (p<0.001) reduction in pain intensity was detected in the Bupivacaine Group compared to the patients in the Standard Analgesia Group at the 1st and 6th h. On the other hand, there was no difference in pain intensity at 12th and 24th h. There was a significant decrease in analgesic use in the bupivacaine group. No major complications or mortality were observed in any patient. Conclusion: Local anesthetic (Bupivacaine) application to the port sites after LC provides a significant decrease in pain intensity in the first 6 h postoperatively. We also believe that fewer analgesic drugs will be used for POP in these patients. ABSTRACT