Publication:

A comparative study of intra-peritoneal instillation of lignocaine versus placebo on operative site in laparoscopic cholecystectomy

Background Visceral nociception is a significant source of the post-operative morbidity in Laparoscopic cholecystectomy and thus the idea of intraperitoneal local anaesthetic (IPLA) instillation was promulgated. The aim of the study was to evaluate the role of intra-peritoneal lignocaine instillation on post-operative morbidity in terms of post-operative pain and post-operative nausea and vomiting and also to establish if there is any difference exists between the timing of instillation of intra-peritoneal lignocaine (before and after completing the gall bladder dissection).

Methods Eighty patients randomized into two groups lignocaine group (lignocaine instilled in gallbladder bed) and placebo group (saline instilled in gallbladder bed). Lignocaine group further divided into subgroups i.e. pre-dissection lignocaine group (lignocaine instilled before gallbladder dissection) and post-dissection lignocaine group (lignocaine instilled after gallbladder dissection).

Results Post-operative pain was measured in terms of the VAS score. The score was less in lignocaine group. The difference was statistically significant (p 0.05).

Conclusions Intraperitoneal lignocaine instillation is an effective method to alleviate post-operative pain in patients undergoing laparoscopic cholecystectomy, whether used as pre-emptive analgesia or instilled at the end of surgery. Intraperitoneal lignocaine instillation decreases post-operative analgesia requirement, especially after the 1st post-operative hour.