INTRAPERITONIAL BUPIVACAINE FOR POSTOPERATIVE ANALGESIA IN LAPAROSCOPIC CHOLECYSTECTOMY: A COMPARATIVE STUDY

Dr. Deepali Valecha*, Dr Gaurav Acharya and Dr Kk Arora

ABSTRACT

Objective: To compare the effect of intraperitoneal bupivacaine for post-operative pain management in patients undergoing laparoscopic cholecystectomy. Material and Methods: Thirty group A patients received 20 ml of 0.9% normal saline as placebo and thirty group B patients received 20 ml of 0.25% bupivacaine. All patients were pre-medicated with glycopyrrolate 0.2mg IM and ondansetron 4 mg IV half an hour prior to induction of anesthesia. All patients were given standard general anaesthesia with propofol (2-2.5 mg/kg), fentanyl 2 μg/kg, and succinylcholine (1.5 mg/kg) to facilitate tracheal intubation. Anesthesia was maintained with 50% N2O in oxygen with 2% sevoflurane. Results: The age and sex distribution of both groups were similar. The heart rate, systolic & diastolic blood pressure, mean blood pressure and mean trend of SpO2 in both groups remained similar over the periods. The mean Visual Analog Score in both groups varied considerably. It was higher in group A at 0 min, 30 minutes, 1 hour, 2 hour, 3 hour, 6 hour and 9 hour after surgery as compared to group B where, at 12 hr and 24 hrs scores were comparable. Time required for rescue analgesia was more in Group B as compared to Group A. Frequency of rescue analgesia and mean number of rescue analgesia doses were more in Group A as compared to Group B. Conclusion: We conclude that intraperitoneal instillation of local anaesthetic is an easy, cheap, and non-invasive method that provides good analgesia in the postoperative period after laparoscopic surgeries.

Keywords: Intraperitoneal Bupivacaine, laparoscopic cholecystectomy, general anaesthesia.