INTRA-PERITONEAL BUPIVACAINE INSTILLATION SIGNIFICANTLY REDUCES PAIN FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Background:

Early pain after laparoscopic cholecystectomy is a process which includes different pain components; laparoscopic cholecystectomy is characterized by a short hospital stay, hence, pain control on the day of surgery is increasingly important. This study was designed to observe the analgesic effect of intraperitoneal bupivacaine instillation in early post-operative period following laparoscopic cholecystectomy.

Methods:

In this Double-blind Randomized clinical trial, 100 participants were selected. These were divided in two groups: Group-1 received 20 ml of 0.25% bupivacaine solution which was instilled in the sub diaphragmatic, hepatic spaces (10ml at each site) at the end of the operation. Group 2 (Placebo) was instilled with 20ml isotonic saline (0.9%) in a similar manner. Post-operative pain free intervals and duration was observed at the time of analgesia administration for 10 hours.

Results:

The mean time of first complaint of pain in group-1 was 5.14 ± 2.89 hours while mean time in group-2 was 1.80 ± 2.01 hours (p- value 0.001). The mean intensity of pain on VAS over 10 hours was higher in the placebo group (mean 6.42) compared to the Bupivacaine group (mean 3.46). All patients, 100%, in placebo group required rescue analgesia within 6 hours after surgery while only 68% in bupivacaine group required analgesia during the same postoperative period.

Conclusion:

Patients instilled with intraperitoneal bupivacaine had decreased intensity of pain. Secondly, following surgery complain of pain in Bupivacaine group was after a significant lapse of time compared to placebo group.