Intraoperative wound infiltration with bupivacaine in patients undergoing elective cholecystectomy

J. J. van Raay, J. A. Roukema and B. W. Lenderink
Department of Surgery, St Elisabeth Hospital, Tilburg, the Netherlands.

In a double-blind randomized trial, 50 patients scheduled for elective cholecystectomy received 50 mL of either 0.25% bupivacaine hydrochloride or physiologic saline by wound perfusion at the end of the operation before wound closure. The duration of incisional infiltration, total amount of postoperative analgesics administered, and total hospital stay were recorded. Pulmonary function tests were performed the day before surgery and 1 day after surgery. There was no difference between the two groups with regard to duration of analgesia, the amount of analgesics administered, or the total hospital stay. Both groups also had similar decrements in forced vital capacity and forced expiratory volume on the first postoperative day. We conclude that wound infiltration with 0.25% bupivacaine after elective cholecystectomy is not effective in reducing postoperative pain. Lung function disturbances cannot be prevented.