Postoperative pain in open vs. laparoscopic cholecystectomy with and without local application of anaesthetic

Aim To evaluate the intensity of postoperative pain and benefits oflaparoscopic cholecystectomy compared to open cholecystectomy especially after anaesthetic infiltration of surgical incision. Methods This prospective cohort study included three groups of 30 patients each, who had undergone surgical treatment by an open procedure, by laparoscopic technique and by laparoscopic technique with local anaesthetic application. All patients were of similar age, sex and ASA risk (American Society of Anaesthesiologists). Pain intensity was assessed seven times and its evaluation was performed using VAS (Visual Analogue Scale). Results Postoperative pain intensity was lower in patients operated by laparoscopic technique compared to the open method, measured on the VAS , especially for the first and second measuring. This difference is pronounced throughout the entire postoperative period (p<0,001). The pain intensity was significantly lower in patients treated with local anaesthetic (p<0.05). Conclusion Laparoscopic cholecystectomy should be preferred over open cholecystectomy with respect to the intensity of postoperative pain, particularly after the application of local anaesthetic.