Abstract
Background:-Cholecystectomy is now widely practised. There are various methods of pain relief.
Aim of our study is to asscess the analgesic effect of intraperitoneal bupivacaine in laproscopic cholecystectomy.
Material and Method:- A prospective randomized study was conducted in which patients were enrolled for group1 (20 ml of saline injected) and group 2 (20 ml of 0.5% of bupivacaine with adrenaline injected). Postoperative pain was assessed by VAS at regular interval, shoulder pain, and requirement of analgesic.
Results:- results shows that VAS score was significantly low (p= <0.001 ) in group 2 at 1,4 and 8 hrs. Pain was low but not statistically significant in 12 and 24 hrs.
Conclusion:- intraperitoneal bupivacaine reduces pain in initial postoperative period after laproscopic cholecystectomy.
Keywords:- bupivacaine, intraperitoneal, laproscopic, VAS score.
References
1. Rademaker BM, Ringers J, Odoom JA, de WL, Kalkman CJ, Oosting J. Pulmonary function an stress response after laparoscopic cholecystectomy: comparison with subcostal incision and influence of thoracic epidural anaesthesia. Anesthesia and Analgesia 1992; 75: 381-385.
2. Joris J, Cigarini, I, Legrand M, Jacquet N, De GD, Franchiment P, Lamy M. Metabolic and respiratory changes after cholecystectomy performed via laparot-omy or laparoscopy. Brit J Anaesth 1992; 69: 341-345
3. Lord Mc Coll. Laparoscopic cholecyste-ctomy. Am R coll Surg Engl: 1992;74:231
4. Rees BI, Williams HR. Laparoscopic Cholecystectomy the first 155 patients. Am R Coll Surg Eng 1992; 74:233-236
5. Scott AND, Greville AC, Mc Millan L, Wellwood J Mc K. Laparoscopic laser cholecystectomy results of the technique in 210 patients Am R Coll Surg; 1992; 74: 237 – 241.
6. Dobbs FF, Kumar V, Alexander JI, Hull MGR. Pain after laparoscopy related to posture and ring versus clip sterilisation. BrJ Obstet Gynaecol 1987; 94: 262-6.
7. Narchi P, Benhamou D, Fernandez H. Intraperitoneal local anaesthetic for shoulder pain after day case laparoscopy. The Lancet 1991; 338: 1569-1570
8. Scheinin B, Kellokiempu I, Lindgren L, Haglund C, Rosenberg PH. Effect of intraperitoneal bupivacaine on pain after laparoscopic cholecystectomy Acta Anaesthesia Scand; 1995; 39: 195-198.
9. Pasqualucci A, Angelis VA, Contrado R et al. Preenptive Anagesia Intraperitoneal local anaesthetic in laparoscopic cholecystectomy. A randomised, double blind, placebo controlled study. Anesthesiology 1996; 85: 11-20
10. Chundrigar T, Morris R, Hedges AR, Starnatakis JD. Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy. Annals R coll surg Engl; 1993; 75:437-439.