Port Site Local Anaesthetics Application Versus Standard Analgesics for Postoperative Pain Control in Laparoscopic Cholecystectomy

Abstract

Introduction: Laparoscopic cholecystectomy is a minimally invasive surgical procedure for removal of a diseased gallbladder which has different post-operative pain management systems. Objective: The objective of this study was to compare pain management in the port sites local anaesthetics and standard analgesics after laparoscopic cholecystectomy (LC). Methodology: A comparative study was conducted on 270 patients with LC under elective conditions for symptomatic cholelithiasis, with a mean age of 49±3.51, treated between 2021 and 2023 in the Department of Surgery at Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh. Patients were divided into the Local Anaesthetics Group (134 patients who received Local Anaesthetics through the port site) and the Standard Analgesia Group (136 patients who received postoperative analgesia with NSAIDs or tramadol). Pain was measured by the Visual Analog Scale (VAS) in all patients at the 1st, 6th, 12th, and 24th postoperatively. Results: Both groups had similar demographic characteristics, surgery duration, and hospitalization. In the local anaesthetics group, the average pain scores at 1st, 6th, 12th, and 24th hours were 3.6, 4.4, 2.1, and 1.9, respectively. For the Standard Analgesia Group, the scores were 7.6, 6.9, 2.3, and 2.1. There was a significant reduction in pain intensity (p<0.001) in the local anaesthetics group at the 1st and 6th hours compared to the Standard Analgesia Group. However, there was no difference in pain intensity at the 12th and 24th hours. Additionally, the use of pain medication decreased significantly in the local anaesthetics group. Conclusion: This study demonstrated that local anesthetic application to the port sites after LC provides a significant decrease in pain intensity in the first 6h postoperatively. The study also found that fewer analgesic drugs will be used for POP in these patients.