Pain Reduction After Cholecystectomy

Combined Preincisional Infiltration and Intraperitoneal Instillation of Levobupivacaine for Postoperative Pain Reduction After Laparoscopic Cholecystectomy; A Double-blind Placebo-controlled Randomised Clinical Trial

To determine the effect of combined intracutaneous infiltration and intraperitoneal instillation of 80 mL 0,125% levobupivacaine prior to the start of laparoscopic cholecystectomy on abdominal pain up to 24 hours after surgery.

The primary endpoint of this study was postoperative abdominal pain as measured by a visual analogue scale (VAS), using a VAS lineal with a slide. The patient was asked to indicate a score from 0 to 100 corresponding to his or her pain. At 0.5, 2, 4, 8 and 24 hours after the surgical procedure the primary investigator visited the patient to obtain the VAS scores.

Inclusion Criteria:

• between 18 and 80
• ASA I or II
• with symptomatic gallstone disease which requires elective laparoscopic cholecystectomy

Exclusion Criteria:

• acute cholecystitis, cholangitis, severe acute pancreatitis, advanced liver cirrhosis or suspected gallbladder cancer,
• a medical history of epilepsy, cardiac arrhythmias or chronic pain of any kind, - allergy to amid type drugs
• pregnancy
• patients suffering from hypotension or hypovolemia
• infectious liver disease
• conditions obstructing adequate pain scoring
• patients using drugs that deduce function of the CYP3A4 or CYP1A2 system
• patients having an American Society of Anaesthesiologists (ASA) classification of three or higher.