Placement of 0.5% bupivacaine-soaked Surgicel in the gallbladder bed is effective for pain after laparoscopic cholecystectomy

Abstract

Visceral pain is prominent after laparoscopic cholecystectomy and can be effectively controlled by 0.5% bupivacaine-soaked Surgicel in the gallbladder bed alone. Trocar-site infiltration alone is ineffective.

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

“…Several variants of LC have been described, but evidence about their effectiveness is scarce (Low quality evidence). On the other hand, there is no evidence of major complications with outpatient LC (Low quality evidence) (Al-Ghnaniem, 2003;Koc, 2003;Harling, 2000;SIGN, 2004;Ladocsi, 1997;Millat, 1997;Thornton, 2002;Kitano, 1993;Barczynski, 2004;Nande, 2002;Trichak, 2003;Novitsky, 2005;Lai, 2003;Zhou, 2006;Corbitt, 1991;Bordelon, 1993;Lane GE, 1993;Janssen, 2003;Cengiz, 2005;Edelman, 1995;Shekarriz, 2003;Bencini, 2003;Yano, 2003;Verma, 2006;Grace, 1991;Martinez Vieira, 2004;Lau, 2002;Pattillo, 2004;Bueno Lledo, 2006).…”

“…The use of various types of ligature and suture as an alternative to conventional stapling is supported by a retrospective cohort81 and two retrospective case series (Yano, 2003;Yeh, 2004). Finally, the use of 0.5% bupivacaine-soaked Surgicel in the gallbladder proved in a cohort study, appear to be effective for control visceral pain after laparoscopic cholecystectomy, but port-site infiltration alone would be ineffective (Verma, 2006)…”

“…In the 90s, LC was regarded as a way to reduce hospital stay in patients undergoing cholecystectomy (Verma, 2006). However, this potential benefit of LC with early discharge versus the standard protocol is supported only by observational studies with non-conclusive results (Grace, 1991;Martinez Vieira, 2004;Lau, 2002;Pattillo, 2004;Bueno Lledo, 2006), (Treatment studies 4).…”

Intraperitoneal Bupivacaine for Postoperative Pain Relief After Laparoscopic Cholecystectomy.

“…This techniquefor relieving postoperative pain iseasy to perform in patients undergoing laparoscopic cholecystectomy. [14][15][16][17][18][19][20] This study was conducted to see the efficacy ofinstillation of 10 ml 0.25% bupivacaine intraperitoneally afterremoval of gall bladder in gallbladder fossa for post-operativepain relief after laparoscopic cholecystectomyand then to apply the same for the future laparoscopic cholecystectomies.…”

Comparison of Pain Relief By Placing Regenerated Oxidized Cellulose Sheet Soaked in Bupivacaine And Port Site Infiltration With Bupivacaine Post-Laparoscopic Cholecystectomy: A Randomized Control Trial

“…Pain management has not been standardized at mass medical centers in India and abroad and this is reflected in the number of different pain studies after LC available in literature. Till day, many different methods have been used with conflicting rates of success to diminish the intensity of PO pain after LC [1][2][3][4][5][6][7][8][9]. They include low pressure pneumoperitoneum, gasless technique of LC, use of warm carbon dioxide, peritoneal wash with saline solution, strict surgical technique, perfect hemostasis, trocar site infiltration of anaesthetic drugs, instillation ofsubdiaphragmatic region with anaesthetic/analgesic drugs, or use of nonsteriodal anti-inflammatory drugs or dexamethasone.…”