The Effect Of Intraperitoneal Bupivacaine For Post-Operative Pain Management In Patients Undergoing Laparoscopic Cholecystectomy- A Prospective Double-Blind Randomized Control Study

Abstract

Objective: To\rcompare the effect of intraperitoneal ropivacaine with placebo for\rpost-operative pain management in patients undergoing laparoscopic\rcholecystectomy. Material and Methods: All patients were pre-medicated with\rglycopyrrolate 0.2 mg,\rondansetron 4 mg and ranitidine 150 mg intravenously half an hour prior to\rinduction of anesthesia. All patients were given standard general anaesthesia\rwith propofol (2-2.5 mg/kg), fentanyl 2 μg/kg, and\rsuccinylcholine (2 mg/kg) to facilitate tracheal intubation. Anesthesia was\rmaintained with 60% N2O in oxygen with 0.5% to 1% Halothane. Group A: Patients\rreceived 20 ml of 0.9% normal saline as placebo (n = 25). Group B: Patients received 20 ml\rof 0.5% ropivacaine (n = 25). Results: The\rage and sex distribution of both the groups was similar. The heart rate, systolic\r& diastolic blood pressure, mean blood pressure and mean trend of SpO2 in both groups remained similar over the periods. The mean VAS varied\rconsiderably within (between time) and between the groups (treatment) and was especially comparatively higher in\rGroup A at initial hours 15 min to 30 min and at end hours 12-24 hrs as compared with Group B. On an average, the frequent\rdosing of rescue analgesia and mean No. of rescue analgesia doses were higher in Group A followed by Group B. In\rboth groups, the treatment related adverse events were mostly emetic symptoms and shoulder pain with\rthe highest being in Group A. Conclusion: We conclude that intraperitoneal\rinstillation of local anaesthetic is an easy, cheap, and non-invasive method which\rprovides good analgesia in the immediate postoperative period after\rlaparoscopic surgery.