Abstract

Introduction: Laparoscopic cholecystectomy causes less postoperative pain than the open procedure, yet pain in the first 24 hours still shapes how quickly patients recover and how much analgesia they end up needing. Instilling local anaesthetics into the peritoneal cavity and at the port sites has been put forward as a straightforward way to bring that pain down. Objectives: To find out whether intraperitoneal plus port-site instillation of bupivacaine works better than giving no local anaesthetic at all in controlling postoperative pain after laparoscopic cholecystectomy. Methods: This randomized controlled study was carried out in the Department of Surgery, Sardar Patel Medical College, Bikaner. Fifty patients scheduled for elective laparoscopic cholecystectomy were randomly split into two groups. Group 1 (n=25) received 0.5% bupivacaine both intraperitoneally and by portsite infiltration, while Group 2 (n=25) received no local anaesthetic. Pain after surgery was scored on the Visual Analogue Scale (VAS) at 1, 8, and 24 hours. The total analgesic dose needed, the time before the first analgesic was requested, postoperative complications, patient comfort, and length of hospital stay were all noted. Data were analysed in SPSS, with p<0.05 taken as significant. Results: Most participants were women (74%), and the largest share fell in the 41– 60 year bracket (46%). Group 1 had noticeably lower pain scores at 1 hour (p=0.03), 8 hours (p=0.008), and 24 hours (p=0.02) than Group 2. Patients in Group 1 also needed less analgesia over the first 24 hours (p=0.001) and went longer before asking for their first dose (p=0.04). Pain relief was rated adequate in 80% of the bupivacaine group compared with just 28% of controls (p<0.001), and satisfaction followed the same pattern (84% vs 28%, p<0.001). Rates of nausea and vomiting were similar in both groups (p=0.48). Conclusion: Combining intraperitoneal and port-site bupivacaine meaningfully lowers postoperative pain and analgesic use after laparoscopic cholecystectomy and leaves patients more satisfied, all without adding to the complication rate. Given how simple and safe it is, this technique deserves a routine place in perioperative pain protocols.

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