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Evaluation of post laparoscopic cholecystectomy pain after subcutaneous injection of lidocaine at port site versus lidocaine spray on gallbladder bed after cholecystectomy: a randomized controlled trial

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Abstract

Purpose

The efficacy of intraperitoneal (IP) and incisional use of local anesthesia in laparoscopic cholecystectomy is a promising subject regarding post-operative pain control. In this study, we aim to compare these methods using lidocaine as the local anesthetic.

Methods

This study was a double-blinded randomized controlled trial. Eighty-two patients, candidates for laparoscopic cholecystectomy, were included. Participants were randomly divided into two equal groups; the instillation group and the infiltration group. In the instillation group, a 2% lidocaine ampule was instilled in the gallbladder bed after removal of the gallbladder. In the infiltration group, a 2% lidocaine ampule was injected subcutaneously into the port sites before making the incisions for the insertion of laparoscopic ports.

Results

The mean age of patients were 41.66 ± 14.44 and 48.05 ± 17.03 years in the instillation and infiltration groups, respectively. The etiologies recorded in this study were: acute calculous cholecystitis (29.3%), symptomatic gallstone (68.3%), and polyp (2.4). The pain severity, evaluated at six different times, from immediately after awakening from anesthesia to 24 h after the operation, was not significantly different between the two groups (p-value = 0.329). Consumption of nonsteroidal anti-inflammatory drugs and narcotics, were statistically lower in the instillation group (p-value = 0.013 and 0.003, respectively). However, hospitalization period, time spent to return to normal bowel movements and oral diet, and postoperative nausea/vomiting were not significantly significant between the groups.

Conclusion

IP instillation of lidocaine following laparoscopic cholecystectomy offers post-operative pain relief and is associated with lower analgesic consumption in comparison to subcutaneous injection of this agent at the port site.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request and with permission of the Research Ethics Committee of the School of Medicine-Arak University of Medical Sciences.

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Author information

Authors and Affiliations

  1. Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran

    Fakhroddin Kiany & Seyed Mostafa Meshkati Yazd

  2. Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Reza Shahriarirad, Hooman Kamran & Mohammadreza Karoobi

  3. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

    Hooman Kamran

  4. Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Nafiseh Shabani Mofrad

  5. Department of Surgery, Arak University of Medical Sciences, Arak, Iran

    Mohammad Kamali

Authors
  1. Fakhroddin Kiany
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Contributions

Fakhroddin Kiany: Study conception and design. Seyed Mostafa Meshkati Yazd: Acquisition of data. Mohammadreza Karoobi: Drafting of the manuscript and critical revision of the manuscript. Reza Shahriarirad: Analysis and interpretation of data. Hooman Kamran: Analysis and interpretation of data. Nafiseh Shabani Mofrad: Critical revision of manuscript. Mohammad Kamali: Critical revision of the manuscript.

Corresponding author

Correspondence to Mohammadreza Karoobi.

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Ethics approval and consent to participate

The study was approved by the Research Ethics Committee of the School of Medicine-Arak University of Medical Sciences. Permission to carry out the study and access patient records was sought from the respective university administrators and therefore all data have been gathered under the ethical standards. Written informed consent for participation was obtained from the patients.

Consent for publication

Written informed consent for publication was obtained from the patients.

Competing interests

The authors declare no competing interests.

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Kiany, F., Meshkati Yazd, S.M., Shahriarirad, R. et al. Evaluation of post laparoscopic cholecystectomy pain after subcutaneous injection of lidocaine at port site versus lidocaine spray on gallbladder bed after cholecystectomy: a randomized controlled trial. Langenbecks Arch Surg 407, 2853–2859 (2022). https://doi.org/10.1007/s00423-022-02645-y

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  • DOI: https://doi.org/10.1007/s00423-022-02645-y

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