Port Site Local Anesthetic Injection Does Not Decrease Postoperative Pain Level or Narcotic Use: A Randomized Blinded Study

Trocar-site pain is a common complaint following laparoscopic cholecystectomy (LC). The purpose of this study was to determine whether local anesthetic use at trocar sites during LC decreases post-operative pain; and whether the timing of anesthetic injection influences this outcome.

Methods and Procedures:
After IRB approval, patients were randomized in a blinded fashion into four groups; Group A (n=33): normal saline (NS) injected at trocar sites before incision+NS before skin closure, Group B (n=30): Local anesthetic (LA, 0.25% Bupivacaine) injected before incision+NS before closure, Group C (n=33): NS before incision+LA before closure, Group D (n=27): no injection. Pain level upon post-anesthesia care unit (PACU) arrival, 30 and 60 minutes post-op were collected by PACU nurses using a Likert scale (1-10). Total dose of narcotic administered in the PACU was recorded. Data were analyzed using one way analysis of variance.

There was no difference in pain scores measured at arrival, thirty or sixty minutes post-op (p=0.99, 0.62 and 0.77 respectively). Additionally, there was no difference in narcotic dosage used among groups while in the PACU (p=0.70).

Local anesthetic use did not decrease post-operative pain or narcotic use after LC. This was true whether local anesthesia was administered prior to skin incision or prior to skin closure.

Session: Podium Presentation

Program Number: S116

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