INTRAPERITONEAL AND LOCAL INFILTRATION OF BUPIVACAINE FOR PAIN RELIEF AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Laparoscopic Cholecystectomy

Abstract

Objective: To compare the effectiveness of intraperitoneal and local infiltration of bupivacaine on pain relief in postoperative period after laparoscopic cholecystectomy.
Study Design: Randomized controlled trial.
Place and Duration of Study: Combined Military Hospital Multan, from Jan to Dec 2014. Material and Methods: In this study, 72 adult patients of either gender with age between 20 to 60 years having symptomatic gallstones scheduled for elective laparoscopic cholecystectomy were divided into two groups. Patients in group A received intraperitoneal and local infiltration of bupivacaine at the end of surgery. Group B was administered placebo. Postoperatively, intensity of pain was recorded by using 10 points’ Visual Analogue Score at 3, 9, 12, 24 hours. A p-value ≤0.05 was considered as statistically significant.
Results: In group A, there were 27 male and 9 female patients while in group B, there were 22 male and 14 female patients. Mean age was 37.75 ± 12.49 years and 41.92 ± 12.73 years in groups A and B respectively. The mean postoperative pain score was 8.18 ± 1, 6.36 ± 0.98, 4.98 ± 1.11 and 3.89 ± 1.11 in group A & 8.72 ± 1.05, 6.91 ± 0.96, 5.92 ± 0.96 and 4.47 ± 1.05 in group B at 3, 9, 12 and 24 hours post operatively. The difference in mean pain scores was significant; 0.0286, 0.0188, 0.0001 and 0.0258 at 3, 9, 12 and 24 hours respectively.
Conclusion: Intraperitoneal and local infiltration of 0.25% bupivacaine significantly reduces the intensity of postoperative pain and analgesic requirement in the early postsurgical hours following laparoscopic cholecystectomy.