Local anesthetic infiltration eases postoperative pain after laparoscopic cholecystectomy

Key findings of the trial:

• Although the mean BMI was greater in the subcutaneous infiltration group (P = 0.001), the groups shared similar clinical characteristics.
• There was no difference between the subcutaneous infiltration and no-infiltration groups (P = 0.999), although the 24-hour cumulative morphine consumption in the rectus sheath infiltration group was considerably lower than in the no-infiltration group (P = 0.043).
• The NRS score did not differ between the three groups at any of the time points from 2 hours after the surgery, but the rectus sheath infiltration group had a significantly lower score than the no-infiltration and subcutaneous infiltration groups at that point (P = 0.006 and P = 0.031, respectively).
• Between the three groups, there was a comparable incidence of nausea or vomiting.
• According to multivariable analysis, increasing morphine usage was linked to age (P = 0.040) and a longer length of operation (P = 0.007), whereas decreased morphine use was linked to rectus sheath infiltration (P = 0.004) and diabetes (P = 0.001).

Although subcutaneous infiltration alone has little effect on pain control, deep local anesthetic infiltration into the rectus sheath reduces early (within 2 h) postoperative pain scores and usage of morphine throughout the first postoperative day after LC, concluded the authors.

REFERENCE

Wikran Suragul, Apawee Tantawanit, Narongsak Rungsakulkij, Paramin Muangkaew, Pongsatorn Tangtawee, Somkit Mingphrudhi, Watoo Vassanasiri, Panuwat Lertsithichai, Suraida Aeesoa, Worapot Apinyachon, Effect of local anaesthetic infiltration on postoperative pain after laparoscopic cholecystectomy: randomized clinical trial, BJS Open, Volume 6, Issue 3, June 2022, zrac066, https://doi.org/10.1093/bjsopen/zrac066