Efficacy of local anaesthetic trocar site local infiltration in cancer patients undergoing laparoscopic colorectal resection: a single-center pilot randomized controlled trial

The OBJECTIVE was to evaluate the efficacy of local anesthetic infiltration of trocar sites (LAITS) as a component of multimodal analgesia in patients undergoing elective laparoscopic colorectal resection for colorectal cancer. METHODS AND MATERIALS. A prospective analysis of 24 patients randomized into two groups was conducted. The study group (n=12) received LAITS in addition to general anesthesia, while the control group (n=12) received general anesthesia combined with thoracic epidural analgesia (TEA). The primary endpoint was the intensity of resting pain assessed using a visual analog scale (VAS) over 2 weeks postoperatively. Secondary endpoints included pain intensity on movement/coughing, length of hospital stay, time to return of bowel function, need for supplemental analgesia, and incidence of surgical complications. RESULTS. Statistically significant differences were found in resting pain intensity at 4, 6, 8, and 12 hours postoperatively (p=0.01), as well as in pain on movement/coughing at 2 (p=0.03), 4, 6, 8, and 12 hours (p=0.01), favoring the control group. The peak VAS score in the study group was 4.65±2.03 points at 6 hours, compared to 1.91±1.63 points at 2 hours in the control group. No significant differences were observed in secondary endpoints, including pain scores at the remaining time points. CONCLUSIONS. In this pilot randomized clinical trial, the LAITS method demonstrated comparable efficacy to TEA method in controlling postoperative pain.