PORT SITE INFILTRATION WITH LIDOCAINE VERSUS CONVENTIONAL ANALGESICS IN CONTROLLING POSTOPERATIVE PAIN FOLLOWING LAPAROSCOPIC SURGERY

Abstract

To compare the effectiveness of port-site infiltration with lidocaine versus conventional systemic analgesics in controlling postoperative pain following laparoscopic cholecystectomy.

Study Design:

Randomised controlled trial.

Place and Duration of Study:

Department of General Surgery, Jinnah Postgraduate Medical Centre (JPMC), Karachi; six months after CPSP/IRB approval.

Methodology:
Ninety patients aged 18–60 years undergoing elective laparoscopic cholecystectomy were randomly allocated into two equal groups. Group A received port-site infiltration with 2% lidocaine (maximum safe dose: 4.5 mg/kg) at the end of surgery, while Group B received conventional systemic analgesics (NSAIDs/opioids) as per hospital protocol. Postoperative pain was assessed using the Visual Analogue Scale (VAS) at 2, 6, 12, and 24 hours by a blinded observer. Requirement and timing of rescue analgesia, along with adverse effects, were recorded. Data were analysed using SPSS version 26, applying t-test for quantitative and Chi-square test for qualitative variables; p ≤ 0.05 was considered significant.

Results:
VAS scores were significantly lower in Group A at all time intervals (p < 0.05). The requirement for rescue analgesia was reduced, and the time to first analgesic request was longer in Group A. No serious adverse effects occurred. Minor side effects such as nausea and vomiting were more frequent in Group B but not statistically significant.

Conclusion:
Port-site infiltration with lidocaine provides superior analgesia, reduces analgesic requirements, and prolongs pain-free periods compared to conventional systemic analgesics after laparoscopic cholecystectomy. It is a safe, effective, and low-cost strategy suitable for incorporation into routine postoperative pain management protocols, especially in resource-limited settings.