A randomized double blinded study to determine the effectiveness of utilizing intraperitoneal bupivacaine: Does it reduce postoperative opioid use following laparoscopic appendectomy?

Abstract

Background: Improving postoperative pain control may lead to improved outcomes including decreased opioid use, shorter hospital stays, and improved patient satisfaction. This study examined the effects of instilling intraperitoneal bupivacaine following laparoscopic appendectomy.

Methods: In this prospective, randomized, double-blinded, placebo-controlled study, patients with appendicitis were randomized to receive either the bupivacaine or normal saline instilled at the appendectomy site prior to close. Postoperative pain scores, opioid doses and length of stay were recorded.

Results: Pain scores were lower (mean 2.48 versus 3.8; p = 0.014), and postoperative opioid use was lower (mean 7.394 mg versus 16.921 mg; p = 0.007) in the bupivacaine group.

Conclusions: Instilling bupivacaine at the base of the cecum at the conclusion of laparoscopic appendectomy was associated with reducing postoperative pain scores and in hospital opioid use.

Statement: This prospective, randomized, double-blinded, placebo-controlled study enrolled subjects with acute appendicitis undergoing laparoscopic appendectomy. Subjects were randomized to receive either bupivacaine or normal saline intraperitoneally at the close of surgery. In the bupivacaine group, pain scores at 1 h were improved and inpatient postoperative opioid use was less.

Keywords: Intraperitoneal local anesthetic; Laparoscopic appendectomy; Postoperative narcotic use; Postoperative opioid use; Postoperative pain.