The use of intraperitoneal bupivacaine to decrease the length of stay in elective laparoscopic cholecystectomy patients.

Abstract This prospective, double-blind, randomized, and placebo-controlled study evaluates the effectiveness of intraperitoneal bupivacaine in decreasing the length of stay for elective laparoscopic cholecystectomy patients. Seventy-seven patients undergoing elective laparoscopic cholecystectomy before noon at a single institution and by a single group of surgeons were entered into the study. The pharmacy randomly assigned each patient to one of four study groups (control, predissection, postdissection, and both). Two syringes (A and B) containing 15 cm3 of either normal saline or 0.5 per cent bupivacaine were sent with the patient to surgery. Syringe A was sprayed over the perihepatic area before any dissection, and B was sprayed over the perihepatic area just before port removal. Preoperative, intraoperative, and postoperative data were collected. Sixty-six patients completed the study: control, 14; predissection, 18; postdissection, 15; and both, 19. There was no statistical difference between the predissection, postdissection, and both groups regarding same-day discharge. Therefore, these groups were combined for comparison against the control group. The study found that patients receiving bupivacaine at any time during the surgery were more likely to go home the same day as their procedure (79% vs 43%, respectively: P < 0.02).