Objective: To study the efficacy of pre-incision infiltration of a local anaesthetic drug in postoperative pain following laparoscopic adrenalectomy.

Material and Method: In a randomized placebo controlled study, 52 patients listed for unilateral laparoscopic adrenalectomy were randomized into 2 groups. Group I (n=26) received subcuticular pre-incision infiltration with 0.5% bupivacaine and group II (n=26) received normal saline as a placebo; all the operations were performed with the same technique by only one experienced laparoscopic urologist. Postoperative pain was assessed using the Visual Analogue Scale at the 4^th, 8^th, 12^th, 24^th, and 48th hour postoperatively as primary outcomes. The secondary outcomes were the total postoperative analgesic consumption and time to the first analgesic demand.

Results: The average pain scores were significantly different at the 4^th, 12^th, 24^th, and 48^th hour postoperatively (p=0.00, 0.00, 0.001, 0.00), but insignificantly different at the 8^th hour (p=0.311). There was no significant difference in nausea/vomiting, bruising score and wound infection (p=0.223, 0.298, 0.313). Postoperative analgesic consumption was significantly lower in the bupivacaine group, but time to the first analgesic demand was not significantly longer in this study.

Conclusion: Our study demonstrated that pre-incision infiltration of a local anaesthetic drug is highly effective for relief of postoperative pain after laparoscopic adrenalectomy in terms of pain perception and intravenous postoperative analgesic consumption without any effects on nausea/vomiting, bruising, and wound infection.