Pre-incisional local infiltration in laparoscopic sleeve gastrectomy

Objectives: Laparoscopic procedures have reduced postoperative pain. Nevertheless, incision-site pain still occurs. Although opioids are the cornerstone of postoperative pain management they have side affects. Moreover increased pain is self-reported at incision sites and abdominal wall. The aim of this study was to evaluate the role of trocar site infiltration with local bupivacaine and lidocaine mixture for pain control after laparoscopic sleeve gastrectomy (LSG). Materials and Method: Forty-six patients undergoing laparoscopic sleeve gastrectomy operation were included the study (23/23). Patients received dexketoprofen trometamol 50mg and tramadol 0.5mg/kg before closure. In Group C, pethidine 100mg was administered additionally. In Group L, patients received 28ml (8 ml for liver elevator site and 5 ml to each trocar site) local anesthetic (LA) mixture (50-50% bupivacaine 5mg/ml-lidocaine %2) before suturation. All patients received PCA with 400mg/100ml tramadol. Opioid consumption, VRS, rescue analgesic, mobilisation time were evaluated. Results: VRS was lower in Group L at 30 minutes, other times were similar. Aldrete scores were higher in Group L at all points. Mobilisation time was shorter, rescue analgesic time was longer, and opioid consumption was less in Group L. Conclusion: LA infiltration to trocar sites in LSG provided good recovery and better pain management with improved patient comfort.