A new effective method to reduce pain after laparoscopic cholecystectomy

Background. The primary aim of this randomized controlled prospective study (www.clinicaltrials.gov NCT00599144) was assessing effectiveness on pain control after video laparoscopic cholecystectomy (VLC) of 0.5% Bupivacaine-soaked sheet of regenerated oxidized cellulose positioned in the gallbladder bed. Patients and methods. We randomized in three equal groups 45 patients that underwent elective videolaparoscopic cholecystectomy: group A - Bupivacaine-soaked sheet of regenerated oxidized cellulose positioned in the gallbladder bed; group B - Bupivacaine infiltrated in the muscular fasciae of the trocars' seat; g roup C - control group, not using local anesthetic. Six and 24 hours after the intervention we recorded the type of the pain and its intensity, using a visual analog scale (VAS). Results. We observed no statistically significant difference in pain intensity. Considering the type of pain, 55,56% of patients referred visceral pain, 62,22% parietal pain and 44,44% shoulder pain. Group A shows, at both endpoints, a statistically significant reduction (p<0.05) of visceral and shoulder pain versus other groups. Moreover the use of a local anesthetic significantly reduces the use of post-operative pain drugs, both for group A and B. Conclusion. A Bupivacaine-soaked sheet of regenerated oxidized cellulose positioned in the gallbladder bedpost-VLC is safe and not economically demanding, and can give advantages in increasing post-operative comfort.