Intraperitoneal Lidocaine and Bupivacaine for Postoperative Pain After Laparoscopic Surgery

The Effectiveness of Intraperitoneal Lidocaine and Bupivacaine Instillation for Reducing Postoperative Pain in Laparoscopic Abdominal Surgery: A Randomized Controlled Trial

The goal of this clinical trial is to determine the safety and efficacy of combined intraperitoneal local anesthetic instillation and port-site infiltration using lidocaine and bupivacaine in adults aged 18 to 60 undergoing elective laparoscopic abdominal surgeries (such as laparoscopic cholecystectomy, appendectomy, or hernia repair). The main questions it aims to answer are: Does combined intraperitoneal local anesthetic instillation and port-site infiltration reduce immediate and early (up to 4 hours) postoperative pain scores? Does this intervention reduce the early need for additional postoperative analgesics and shorten the length of hospital stay? Researchers will compare the treatment group receiving lidocaine (2%) and bupivacaine (0.5%) by intraperitoneal instillation and port-site infiltration with a control group receiving normal saline by the corresponding routes to determine whether the local anesthetic intervention reduces postoperative pain and analgesic requirements. Participants will undergo scheduled elective laparoscopic abdominal surgery and receive either the local anesthetic intervention or normal saline during the surgical procedure. Pain will be assessed using the Visual Analog Scale (VAS) immediately after surgery in the recovery room and again at 2 and 4 hours after surgery. Analgesic needs will be monitored and documented, and total hospital stay will be recorded.

Inclusion Criteria:

• Adults aged 18 to 60 years.
• Scheduled for laparoscopic abdominal surgery (e.g., laparoscopic cholecystectomy, laparoscopic appendectomy, or laparoscopic hernia repair).
• American Society of Anesthesiologists (ASA) physical status I or II.
• No history of chronic pain, opioid dependence, or severe medical comorbidities.
• Able and willing to provide written informed consent.

Exclusion Criteria:

• Conversion from laparoscopic to open surgery.
• Acute cholecystitis, gangrene, or empyema of the gallbladder.
• Oncologic or extensive laparoscopic procedures expected to have a prolonged operative time.
• Known allergy or hypersensitivity to lidocaine, bupivacaine, or other local anesthetic agents.
• Diabetes mellitus.
• Current systemic corticosteroid use.
• Pregnancy.
• Cardiac, pulmonary, hepatic, or renal disorders.
• History of opioid use or opioid dependence.