This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .
Randomized, controlled trial of bupivacaine injection to decrease pain after laparoscopic cholecystectomy.
OBJECTIVES To determine if intraoperative instillation of bupivacaine would decrease early postoperative pain  after laparoscopic cholecystectomy , if the patients would consequently require less narcotic postoperatively and if such patients would elect to be discharged on the day of operation if given the choice . DESIGN Double-blind , r and omized , controlled trial . SETTING A tertiary care hospital in Hamilton , Ont . PATIENTS Fifty patients underwent laparoscopic cholecystectomy . Day-surgery patients had the choice of staying overnight for discharge the following day . They were compared with a control group of 47 patients who had laparoscopic cholecystectomy but did not receive bupivacaine .  INTERVENTION Instillation of 20 mL of 0.5 % bupivacaine with epinephrine into laparoscopic cholecystectomy port sites intraoperatively before closure . MAIN OUTCOME MEASURES Visual analogue scale ( VAS ) pain scores assessed 4 times postoperatively , the choice of patients to leave hospital the same day or to remain in the hospital overnight ; the level of postoperative narcotic usage . MAIN RESULTS Mean VAS pain scores ( range 0 [ no pain ] to 5 [ severe pain ] ) at less than 2 hours and at 6 hours after surgery were 2.9 and 2.9 , respectively , in the bupivacaine group compared with 4.5 and 4.0 , respectively , in the control group ( p = 0.001 and 0.025 ) . VAS scores at 10 hours postoperatively and the next morning did not differ between the groups . More patients in the bupivacaine group elected to go home on the day of surgery ( p = 0.034 ) . Narcotic usage was not significantly different . CONCLUSION Instillation of bupivacaine into port sites should be st and ard practice for elective laparoscopic cholecystectomy
This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .