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 .
Bupivacaine instillation into gallbladder bed after laparoscopic cholecystectomy: does it decrease shoulder pain?
BACKGROUND Shoulder pain is common after  laparoscopic cholecystectomy  ( 60.5 % ) and can delay return to normal activities . The cause is unclear but may involve referral of pain from the traumatized area . PATIENTS AND METHODS A total of 75 patients with chronic cholecystitis who underwent laparoscopic cholecystectomy  were r and omized into two groups . Group I ( 37 patients ) had 10 mL of 0.25 % bupivacaine instilled into the gallbladder bed and Calot 's triangle area at the end of cholecystectomy . Group II ( 38 patients ) served as controls and had no bupivacaine instillation .  Postoperative shoulder pain was evaluated . RESULTS Six patients in Group I developed shoulder pain ( 16 % ) compared with 23 patients in Group II ( 60.5 % ) . The difference was statistically significant ( P = 0.0002 ) . CONCLUSION The raw area of the removed organ is at least partially responsible for shoulder pain after laparoscopic cholecystectomy . Local bupivacaine is effective in reducing such pain
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 .