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

Introduction:
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.

Results:
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).

Conclusion:
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

« Return to SAGES 2009 abstract archive