Intraperitoneal aerosolization of bupivacaine reduces postoperative pain in laparoscopic surgery: a randomized prospective controlled double-blinded clinical trial

Surg Endosc. 2007 Apr;21(4):602-6. doi: 10.1007/s00464-006-9087-6. Epub 2006 Dec 16.


Background: Laparoscopic strategies for managing intraabdominal pathologies offer significant benefits compared with conventional approaches. Of interest are reports of decreased postoperative pain, resulting in shorter hospitalization and earlier return to normal activity. However, many patients still require strong analgesia postoperatively. This study analyzed the use of intraoperatively delivered aerosolized intraperitoneal bupivacaine and its ability to reduce postoperative pain.

Methods: For this study, 80 patients undergoing laparoscopic cholecystectomy were recruited and divided randomly into four groups: control (n = 20), aerosolized bupivacaine (n = 20), aerosolized normal saline (n = 20), and local bupivacaine in the bladder bed (n = 20). All the patients had standard preoperative, intraoperative, and postoperative care. Pain scores were recorded by the nursing staff in recovery, then 6, 12, and 24 h postoperatively using a standard 0 to 10 pain scoring scale. In addition, opiate consumption and oral analgesia were recorded.

Results: Aerosolized bupivacaine significantly reduced postoperative pain in comparison with all other treatments (p < 0.05). Injection of bupivacaine into the gallbladder bed did not result in a significant difference from the control condition.

Conclusion: Aerosolized intraperitoneal local anesthetic is an effective method for controlling postoperative pain. It significantly helped to reduce opiate use and contributed to rapid mobilization, leading to short hospitalization and possible reduction in treatment cost.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aerosols / administration & dosage*
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Anesthetics, Local / administration & dosage
  • Bupivacaine / administration & dosage*
  • Cholecystectomy, Laparoscopic / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intraperitoneal
  • Intraoperative Care / methods*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Pain Measurement
  • Pain, Postoperative / prevention & control*
  • Patient Satisfaction
  • Probability
  • Treatment Outcome


  • Aerosols
  • Anesthetics, Local
  • Bupivacaine