Intraperitoneal Analgesia After Laparoscopic Cholecystectomy
Intraperitoneal Analgesia After Laparoscopic Cholecystectomy
Although laparoscopic cholecystectomy is associated with less pain than contemporary open
 procedures; it is definitely not pain free and the magnitude of postoperative shoulder and
 abdominal pain in the early postoperative period is still quite significant. This
 postoperative pain is a major concern not only for the patients, but also healthcare workers;
 and it often contributes to overnight hospital stay after this minimally invasive surgical
 procedure. Intraperitoneal instillation of local anesthetics at the time of surgery to
 control pain after laparoscopic cholecystectomy has been extensively studied in numerous
 randomized trials and found to be extremely useful. Lignocaine and Bupivacaine are two
 commonly used local anesthetic agents. In view of contradictory results from previous
 studies, it is not yet clear which of these two agents is superior to the other for pain
 control in this setting. To answer this question, we have designed a prospective randomized
 controlled trial and the specific aim of the study is to compare the analgesic efficacy of
 intraperitoneal lignocaine with intraperitoneal Bupivacaine in the postoperative setting
 after laparoscopic cholecystectomy.

 If we can improve pain control after this minimally invasive procedure, it might result in
 decreased postoperative requirement of narcotic analgesia and its associated side-effects. It
 may also result in early recovery and the same day discharge of the patients with significant
 cost-containment for the patient and healthcare systems in future.
Inclusion Criteria:

 -  Diagnosis of symptomatic gallstones requiring laparoscopic cholecystectomy

 -  Elective surgical procedure

 -  American Society of Anesthesiologists class I and II

 Exclusion Criteria:

 -  Patients refusing randomization

 -  Patients already on analgesics

 -  Patients with acute cholecystitis

 -  Patients requiring preoperative cholangiogram or common bile duct exploration

 -  Patients having bile or stone spillage during procedure

 -  Patients requiring conversion to open procedure

 -  Patients requiring re-exploration for any reason

 -  Patients with history of allergy to local anesthetic agents