Laparoscopic cholecystectomy is the treatment of choice for symptomatic cholelithiasis, laparoscopic cholecystectomy result in less post-operative pain compared with open cholecystectomy, post-operative pain after laparoscopic cholecystectomy remain an issue ,pain can prolong hospital stay and lead to increased morbidity; the type of pain after laparoscopy differs from that observed after laparotomy, patients complain more of visceral pain after laparoscopy. Shoulder pain secondary to diaphragmatic as a result if CO2 pneumoperitoneum after laparoscopy surgery. Pain after laparoscopy may be moderate or even severe for some patients and may require opioid treatment. Although opioid have played a prominent role in reduce of post-operative pain, but the side effect such as ilius and vomiting and nausea may limit their future use in some patients. Several authors have reported a substantial decrease in post-operative pain after laparoscopic cholecystectomy with the use of intra peritoneal local anesthesia. The aim of this study is to compare the lidocaine and bupivacain with normal saline on reduce pain and vomiting and nausea after cholecystectomy laparoscopic.
Material and methods: A total of 168 patients undergoing laparascopic cholecystectomy were randomly assigned to three groups (Group A, Group B, and Group C). On the completion of cholecystectomy, 20 mL of lidocaine 1% was infused intraperitoneally in Group B, 20 mL of Bupivacain 0.25% was infused intraperitoneal in Group C, and 20 mL of normal saline was infused intraperitoneally in Group A. The incidence and severity of PONV, the pain score, and the rescue analgesics were assessed 0 min, 15 min, 30 min, 1 h, 2 h, 6 h, 12 h, and 24 h after surgery.