The analgesic effect of intraperitoneal bupivacaine has been widely studied, but with controversial results.
OBJECTIVE: To determine the efficacy of intraperitoneal bupivacaine on  producing  postoperative  analgesia  in  patients  who  underwent laparoscopic  cholecystectomy.
METHODS: A systematic literature search on the use of intraperitoneal bupivacaine in reducing postoperative pain was done using Medline and Cochrane. The search yielded 6 randomized controlled trials,involving a total of 440 patients. Mean differences in visual analog pain score at 0, 2, 4, 6, 8, 12, and 24 hours post-surgery were pooled using random effects model.
RESULTS: Overall, there was a significant reduction of pain score in the bupivacaine group with VAS score of -0.55 cm (95% CI, -0.80 to -0.31). Subgroup analysis at 0, 2, 4, 6, 8, and 12 hours post-surgery showed statistically significant mean differences in the VAS score of  -1.59 cm (95% CI, -2.31 to -0.86), -0.60 cm (95% CI, -1.02 to -0.17), -0.80 cm  (95% CI, -1.34 to -0.26),  -0.85 cm  (95% CI, -1.46 to -0.24), -0.64 cm  (95% CI, -1.12 to -0.16), and -0.38 cm  (95% CI,-0.68  to  -0.08),  respectively,  in  favor  of  the  bupivacaine  group.However,  at  24  hours  post-surgery,  there  was  no  statistically significant mean difference in the VAS score of -0.09 cm (95% CI,-0.49 to 0.31).
CONCLUSION: Intraperitoneal bupivacaine instillation among patients undergoing laparoscopic cholecystectomy is effective in providing postoperative analgesia specifically in the first 12 hours post-op.