The Ideal Local Anesthetic for Intraperitoneal Gallbladder Bed Infiltration Following Laparoscopic Cholecystectomy

Pakistan Air Force (PAF) Hospital Islamabad

Status: Completed

Conditions: Pain Management; Cholecystectomy, Laparoscopic

Treatments: Procedure: Local Anesthesia

Study type: Interventional

Funder types: Other

Identifiers

NCT06605235

SGR-2021-137-2499-1 (Other Identifier)

Details and patient eligibility

About

To control pain after surgery for removal of gallbladder, local anesthetic agent can be sprayed on the liver bed from where the gallbladder is removed. This study was conducted to identify the ideal local anesthetic agent for this purpose.

Full description

Laparoscopic cholecystectomy is the gold standard operation for symptomatic cholelithiasis; however, pain remains a major factor increasing morbidity and length of hospital stay. Infiltration of gallbladder bed with local anesthetic has been shown to improve post-operative pain after laparoscopic cholecystectomy, although, it is unclear which local anesthetic provides superior pain relief. Patients undergoing laparoscopic cholecystectomies were randomized into 3 groups of 30 patients each depending on the local anesthetic instilled in the gallbladder bed; lignocaine (Group A), bupivacaine (Group B), or a combination of lignocaine and bupivacaine (Group C). Pain was measured using visual analogue score at 2-, 6-, 12- and 24-hours following surgery

Enrollment: 90 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• elective/emergency laparoscopic cholecystectomy
• ASA grade I/II
• Ages 18-75 years

Exclusion criteria

• patients on chronic analgesics
• pts receiving analgesics 24 hours prior to surgery
• intraoperative bile spillage or drain placement
• CBD exploration or T-tube insertion
• BMI > 40 kg/m2
• pts allergic to, or otherwise not able to receive medications being tested

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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90 participants in 3 patient groups

Lignocaine

Experimental group

Description:

patients received 20 ml of 1% lignocaine (Xyloaid-lignocaine HCl injection) infiltrated in the gall bladder bed after removal of the gall bladder, along with 10 ml of 1% lignocaine infiltration at the port sites at the end of the procedure

Treatment:

Procedure: Local Anesthesia

Bupivacaine

Experimental group

Description:

Subjects received 20 ml of 0.25% bupivacaine (Bupicain-Bupivacaine HCl injection) infiltration in gall bladder bed, along with 10 ml of 0.25% bupivacaine at port sites

Treatment:

Procedure: Local Anesthesia

Lignocaine + Bupivacaine

Experimental group

Description:

patients received 10 ml of 1% lignocaine along with 10 ml of 0.25% bupivacaine infiltrated in gall bladder bed, and then 5 ml of 1% lignocaine along with 5 ml of 0.25% bupivacaine at the port sites

Treatment:

Procedure: Local Anesthesia