Irrigation of Bupivacaine at the Surgical Bed for Postoperative Pain Relief After Laparoscopic Cholecystectomy for Acute Cholecystitis

This study aims to compare the effectiveness of irrigation of 0.5% bupivacaine versus normal saline at the gallbladder surgical bed in reducing postoperative pain following laparoscopic cholecystectomy for acute cholecystitis. Postoperative pain remains a common concern despite the minimally invasive nature of laparoscopic surgery. The study evaluates pain intensity at 4, 8, and 12 hours after surgery using the Visual Analogue Scale (VAS).

Inclusion Criteria: * Age 18 to 60 years * Acute cholecystitis confirmed by clinical findings (epigastric pain, abdominal tenderness, positive Murphy sign), ultrasound or CT findings (gallbladder wall thickening, pericholecystic fluid), and raised total leucocyte count and C-reactive protein * Planned for laparoscopic cholecystectomy * American Society of Anesthesiologists (ASA) physical status I or II * Presentation within one week of symptom onset * Able to provide written informed consent Exclusion Criteria: * Known allergy to amide local anaesthetics * Uncontrolled hypertension * Documented psychiatric disorder * Gallbladder empyema, mucocele, or perforation * Conversion to open cholecystectomy