276 Intraperitoneal Local Anaesthetic Infiltration Use in Laparoscopic Sleeve Gastrectomy

Abstract Aim Post-operative pain management following laparoscopic sleeve gastrectomy can be challenging (1). Local anaesthetics (LA) are often used as part of a multi-modal analgesic regimen. In bariatric surgery, intraperitoneal local anaesthesia (IPLA) has been reported to reduce pain and analgesic consumption (2). Our unit employs various methods of local anaesthetic infiltration depending on the operator. This study aims to investigate whether the use of IPLA in our unit reduces postoperative opioid requirements. Method Data was collected retrospectively on all laparoscopic sleeve gastrectomy operations performed at our unit between February 2020 and February 2025, a total of 35 patients. Two patients using Patient Controlled Analgesia were excluded due to lack of charts. A total of 10 patients received IPLA. IPLA doses given were 20mls of either 0.25% Levobupivacaine or 0.2% Ropivacaine, depending on local supply. Opioid doses used in both recovery and in the first 24 hours on the ward were converted to their oral morphine equivalent (OME) for direct comparison. Results The mean OME in recovery was 23mg in those not receiving IPLA versus 49mg in those receiving IPLA. The mean OME in the first 24 hours on the ward was 25mg in those not receiving IPLA versus 11mg in those receiving IPLA. Conclusions Intraperitoneal local anaesthetic did not reduce opioid requirement in recovery. However, there appears to be a benefit in the first 24 hours post-operatively with a reduction in opioids needed. Therefore, depending on surgical preference, we would recommend IPLA as a tool to aid post-operative pain manage.