Intraperitoneal Techniques of Local Anaesthesia During Laparoscopic Cholecystectomy
Intraperitoneal Techniques of Local Anaesthesia During Laparoscopic Cholecystectomy
Pain following laparoscopic cholecystectomy (LC) results in morbidity and is a barrier to
 same day discharge. In several trials local anaesthetic (LA) washed over the liver and gall
 bladder decreases pain. In many patients pain has a strong component attributable to
 diaphragmatic origin. A wash of LA over the liver and gall bladder is unlikely to provide
 high levels of analgesia to pain fibres from the diaphragm. The investigators hypothesise
 that LA injected to the right hemidiaphragm during LC would be more effective than wash.

 Methods Double blind randomised controlled trial of 128 consecutive subjects undergoing
 elective LC. Control -sham injection of diaphragm and sham wash over liver/GB with saline;
 Test treatment 'subperitoneal LA' - bupivocaine injection/sham wash; Internal control
 'topical LA' - sham injection/bupivocaine wash. Primary outcome: pain scores in theatre
 recovery and the ward. Secondary outcomes: analgesic use, physiological observations, time to
 eating and mobilising, day case surgery.
Inclusion Criteria:

 -  Elective laparoscopic cholecystectomy

 -  18 years old or over

 Exclusion Criteria:

 -  Emergency surgery

 -  Under 18 year olds