Efficacy of high-volume low- concentration intraperitoneal bupivacaine irrigation for post operative analgesia in patients undergoing laparoscopic cholecystectomy

Effective post operative analgesia after laparoscopic cholecystectomy remains a clinical challenge. Recently, instillation of different local anaesthetics (LAs) intraperitoneally has gained popularity for post-operative analgesia in laparoscopic cholecystectomy. Most of the studies have used bupivacaine irrigation of peritoneal cavity in low volume(20ml to 100ml) and high concentration(0.125%-0.5%). However, their analgesic action is effective for only a few hours in the post-operative period.

Recently low concentration(0.02%)  but high volume (500 ml) of bupivacaine has been used for intraperitoneal irrigation in order to cover large sub hepatic area and surrounding peritoneum thereby producing more effective analgesia. It significantly increased duration of analgesia and reduced opioid requirement after laparoscopic cholecystectomy.