| Summary: | BACKGROUND:
Laparoscopic cholecystectomy, although is less invasive than open surgery, is not completely pain free. The
use of local anaesthesia to relieve pain following this procedure is a common practice. However, it remains
debatable whether a pre- or post-operative drug administration is more effective. Here, we investigated
the role of preemptive local anaesthetic infiltration given pre- or post-incisional, in relieving the pain during
laparoscopic surgery.
METHODOLOGY:
A randomized controlled trial was conducted with 96 patients receiving 0.5% Bupivacaine 100mg. Group A (n=48) received post-incisional skin infiltration whilst Group B (n=48) received pre-incisional infiltration. Incisional (somatic) and intra-abdominal (visceral) pain was assessed using Visual Analog Scale (VAS) at day 0, day 1 and day 7 post-operative days.
RESULT:
Baseline characteristics between the two groups were similar. Incisional pain was lower in Group B as compared
to Group A at day 0 (P=0.03) and day 1 (P<0.01). Intra-abdominal pain was also lower in Group B at day 0 and
day 1 (P=0.04). VAS score was similar at day 7 although analgesia requirement is higher in Group A (P>0.05).
CONCLUSION:
Administration of pre-incisional local anaesthesia offers better pre-emptive pain relief measure than post-incisional administration by reducing somatic and visceral pain in laparoscopic gall bladder surgery.
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