Title: A Comparison of Intraperitoneal Instilllation of Bupivacaine - Tramadol with Bupivacaine - Magnesium Sulphate for Pain Relief after Laparoscopic Cholecystectomy
Authors: Dr Syed Ali Aasim, Dr K.Anil Kumar, Dr Ganesh Suram
DOI: https://dx.doi.org/10.18535/jmscr/v5i9.108
Abstract
Background: Recently the use of local anaesthetics, instilled intraperitoneally, alone or mixed with other drugs, after laparoscopic cholecystectomy to reduce post operative analgesia is attaining popularity.
Aims and Objectives: To compare the quality and duration of post-operative analgesia using intraperitoneal Bupivacaine plus Tramadol (BT) and Bupivacaine plus Magnesium sulfate (BM) in patients operated for laparoscopic cholecystectomy.
Materials and Methods: We carried out a prospective, randomised, double-blind study in 50 patients aged between 20 to 45 years undergoing laparoscopic cholecystectomy with ASA grade 1 and 2. They were randomly divided into two groups of 25 each, Group BT: were given 0.25% 30 ml bupivacaine and 100 mg tramadol and Group BM: were given 0.25% 30ml bupivacaine and 50 mg MgSO4. The parameters assessed and compared were the analgesic efficacy. duration of pain relief and associated side effects.
Results: We found more number of females than males, but difference was not statistically significant difference (P > 0.05). We did not find any statistically significant difference between the groups with respect to the duration of anaesthesia (P > 0.05). We found that the post operative pain relief was 1 to 2 hours more for BM group compared to BT group, the difference being statistically significant. We found that no side effects occurred in patients of both groups except nausea and vomiting in two patients in BT group which was statistically not significant (P > 0.05).
Conclusion: lntraperitoneal instillation of Bupivacaine-MgS04 combination provides good analgesia in first 24 hours after surgery, with longer duration of pain free period when compared to Bupivacaine-Tramadol combination,
Keywords: Bupivacaine, Cholecystectomy, Intraperitoneal, Magnesium Sulphate, Tramadol.
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