Brief Summary
Postoperative pain remains a common problem after laparoscopic abdominal surgery despite the minimally invasive nature of these procedures. Pain mainly arises from the trocar insertion sites, tissue manipulation, and the effects of pneumoperitoneum. Although systemic analgesics are routinely used, they may not provide adequate pain relief and can be associated with adverse effects.
This prospective randomized controlled trial aims to evaluate whether pre-incisional infiltration of bupivacaine at laparoscopic trocar insertion sites reduces postoperative pain compared with standard care without local anesthetic infiltration. A total of 166 adult patients undergoing elective laparoscopic abdominal surgery will be randomly assigned to receive either local bupivacaine infiltration before skin incision or no local anesthetic infiltration. All participants will receive the same standard perioperative care and postoperative analgesic regimen.
The primary outcome is postoperative pain intensity measured using the Visual Analog Scale (VAS) during the first 24 hours after surgery. Secondary outcomes include the time to first rescue analgesic, total opioid consumption within the first 24 hours, and overall postoperative pain control. The results of this study may help determine whether local bupivacaine infiltration is an effective, simple, and low-cost addition to multimodal analgesia for patients undergoing laparoscopic abdominal surgery.
Inclusion Criteria:
Adults aged 18 to 60 years. Scheduled for elective laparoscopic abdominal surgery (e.g., cholecystectomy, appendectomy, or hernia repair).
American Society of Anesthesiologists (ASA) physical status I or II. Able to understand and use the Visual Analog Scale (VAS) for pain assessment. Willing and able to provide written informed consent.
Exclusion Criteria:
Intraoperative conversion to open laparotomy. Known allergy, hypersensitivity, or contraindication to bupivacaine or other amide local anesthetics.
Pregnancy or breastfeeding. History of chronic pain syndromes or regular use of opioid or non-opioid analgesics before surgery.
History of substance abuse or severe psychiatric disorders that may affect pain perception.
Local skin infection at the planned trocar insertion sites.
jawadqamar22@gmail.com
Participants undergoing elective laparoscopic abdominal surgery will receive pre-incisional infiltration of 20 mL of 0.5% bupivacaine diluted with 20 mL of normal saline (final concentration 0.25%). The solution will be equally infiltrated into the planned trocar insertion sites before skin incision in addition to standard perioperative care.
Participants undergoing elective laparoscopic abdominal surgery will receive standard perioperative care and postoperative analgesia without local bupivacaine infiltration at the trocar insertion sites.
Faisalābad, Punjab Province 38000, Pakistan
jawadqamar22@gmail.com00923060403567
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