Background :
Laparoscopic cholecystectomy results in less postoperative pain compared to open cholecystectomy. However, postoperative pain remains a concern after the procedure, which may prolong hospital stay and increase morbidity.
Objectives :
Effective postoperative pain management helps early mobilization, reduces analgesic requirements, enables early hospital discharge, and allows faster return to normal activities and work. This also reduces overall treatment cost and loss of working days.
Methods :
This randomized controlled trial included 100 patients undergoing routine laparoscopic cholecystectomy at Pabna Medical College Hospital from March 2015 to May 2016. Patients were randomly assigned to a control group and a bupivacaine group. In the bupivacaine group, local anesthetic (bupivacaine) was infiltrated at port sites, including skin, subcutaneous tissue, fascia, and liver bed at the end of surgery. The control group received normal saline in the same manner.
Postoperative pain was assessed using a visual analogue scale at 4, 12, and 24 hours after surgery, at discharge, and at one week postoperatively. Data on first analgesic request, total analgesic consumption, and return to normal activities and work were also recorded.
Results :
Patients receiving bupivacaine infiltration had significantly lower pain scores at all assessment points compared to the control group. They also experienced a longer delay before requesting the first analgesic dose and required fewer total analgesics during the postoperative period.
Conclusion :
Bupivacaine infiltration at port sites and liver bed after laparoscopic cholecystectomy is an effective method for postoperative pain control. It reduces analgesic requirements and supports fast-track recovery.