Randomized, controlled trial of bupivacaine injection to decrease pain after laparoscopic cholecystectomy (original) (raw)
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JSLS : Journal of the Society of Laparoendoscopic Surgeons, 2012
The aim of this study was to evaluate the effect of bupivacaine irrigated at the surgical bed on postoperative pain relief in laparoscopic cholecystectomy patients. Methods: This study included 60 patients undergoing elective laparoscopic cholecystectomy who were prospectively randomized into 2 groups. The placebo group (nϭ30) received 20cc saline without bupivacaine, installed into the gallbladder bed. The bupivacaine group (nϭ30) received 20cc of 0.5% bupivacaine in at the same surgical site. Pain was assessed at 0, 6, 12, and 24 hours by using a visual analog scale (VAS). Results: A significant difference (Pϭ.018) was observed in pain levels between both groups at 6 hours postoperatively. The average analgesic requirement was lower in the bupivacaine group, but this did not reach statistical significance. Conclusions: In our study, the use of bupivacaine irrigated over the surgical bed was an effective method for reducing pain during the first postoperative hours after laparoscopic cholecystectomy.
International Surgery Journal
Background: The aim of this study was to compare the efficacy of infiltration of local anaesthetic bupivacaine at incision site (port site) and intraperitoneally on postoperative pain in patients undergoing laparoscopic cholecystectomy.Methods: This was a randomized controlled study carried out on patients undergoing laparoscopic cholecystectomy. The patients were divided into three groups of 60 patients each. Group 1 was the control group which did not receive either intraincisional or intraperitoneal bupivacaine. Group 2 received intraincisional bupivacaine 0.25% 20 ml, while group 3 received 20 ml solution of bupivacaine 0.25% 20 ml intraperitoneally. Postoperative pain was recorded for 24 hours post-operatively.Results: The incidence of abdominal pain was significantly lower in the group which received intraincisional bupivacaine upto 12 hours postoperatively. Right shoulder pain was low in group receiving intraperitoneal bupivacaine as compared to group 2, but it was not stat...
Background: Effective control of postoperative pain reduces the postsurgical discomfort and facilitates early ambulation. We evaluated the efficacy of trocar sites and intra peritoneal administration of bupivacaine in reducing the postoperative pain and analgesic requirement. Materials and methods: Sixty adult ASA physical status Ι to ΙΙΙ patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either, 30 ml of 0.25% bupivacaine at gall bladder bed plus 20 ml of 0.25 % bupivacaine at trocar sites (Group B) or an equal volume of normal saline (Group S). Postoperative pain was assessed using 10 point Visual analogue scale every four hours for 12 hours. The total analgesic consumption in 12 hours was also assessed. Results: The mean pain total pain score were significantly less (< 0.0001 ) in Group B (2.03±0.9289) when compared to Group S (4.266±0.4767). Total tramadol consumption decreased by 56% in Group B (113.33 ± 34.57mg) compared to Group S (256.66 ± 50.4 mg).The variation was statistically significant(p < 0.0001). Total consumption of diclofenac was significantly (p < 0.0001) less in Group B than Group S (7.5±22.884 Vs 55±33.733mg). Conclusion: Local anaesthetic administration is an effective component of multimodal analgesia for reducing postoperative pain and opioid requirement after laparoscopic cholecystectomy
Effect of intraperitoneal bupivacaine on pain after laparoscopic cholecystectomy
Acta Anaesthesiologica Scandinavica, 1995
The effect of intraperitoneal bupivacaine on postoperative pain was studied in 60 ASA 1–2 patients undergoing elective laparoscopic cholecystectomy. The patients were randomly selected (20 patients in each group) to receive in double-blind fashion 100 ml of either plain 0.15% bupivacaine {150 mg · 100 ml-1) or the same solution with adrenaline (1.5 μg ml-l), or the same volume of saline into the right subdiaphragmatic space at the end of surgery. The patients were kept in the Trendelenburg's position for 20 min after the instillation. Venous blood samples for the determination of bupivacaine plasma concentrations were drawn up to 180 min. Plasma bupivacaine concentrations peaked at 30 min (highest individual value 2.6 μg ml-1) after instillation. Bupivacaine concentrations were significantly lower in the bupivacaine-adrenaline group. During the follow-up no difference between the groups occurred as to the time to first demand of analgesia, severity of postoperative pain, amount of consumed analgesics during 7 days, and length of hospitalization. In all groups, 30–45% of the patients complained of right shoulder pain. After the first 24 hours, pain at rest and during moving was reported as mild and was managed with oral ketoprofen.It is concluded that postsurgical intraperitoneal instillation of 150 mg bupivacaine in 100 ml of saline had no effect on pain after laparoscopic cholecystectomy.
2021
Background: Port site pain remains prevalent complaint of early postoperative period after laparoscopic cholecystectomy. Objectives: to see the analgesic efficacy of port-site infiltration of bupivacaine in laparoscopic cholecystectomy. Methodology: This randomized controlled clinical trial was conducted in the Department of Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet from September 2017 to March 2018. Sixty patients underwent laparoscopic cholecystectomy were randomized into experimental group and control group by odd and even number respectively. Infiltration of 0.5% bupivacaine was at port sites subcutaneously in experimental group and none in control group. Postoperative pain intensity was measured using Numeric Rating Scale (NRS) at 6, 12, 24 and 48 hours. Results: Pain score was lesser in experimental group compared to control group at 6, 12, 24 and 48 hours (p< 0.001). The amount of opioid analgesic needed (p=0.006) and hospital stay (p=0.048) were signific...
International Journal of Research in Medical Sciences, 2016
Background: Pain following laparoscopic surgery is multifactorial, arising from trocar sites (somatic pain), operative site (visceral pain) and shoulder pain (referred from diaphragmatic irritation because of pneumo-peritoneum). Currently no standard of care exists to reduce post-operative pain by use of local analgesia in laparoscopic cholecystectomy. Despite many studies, there are contradictory results. Aim of the study was to assess whether instillation of local anaesthetics at trocar sites and intraperitoneally, reduces the amount of pain experienced in the immediate postoperative period after laparoscopic cholecystectomy. Methods: This prospective study was carried out in the Department of General Surgery in a tertiary medical Centre in Mumbai. 75 subjects were randomized into 2 groups. Group A consisting of 38 patients were subjected to multisite instillation of LA combination (bupivacaine+xylocaine) at trocar site, gall bladder fossa, sub diaphragmatic space. Group B, (control group) consisting of 37 patients was given no such LA. Post operatively, pain was assessed by VAS scale (0-100) at 1,4,24 hours. Both the groups were compared and analysed. Results: Group A showed significantly reduced pain scores at 1, 4 and 24 hours post operatively as compared to group B. Conclusions: Our results indicate that multisite infiltration of local anesthetic combination (bupivacaine+xylocaine) after laparoscopic cholecystectomy surgery significantly reduces pain at 1, 4 and 24 hours postoperatively.
2015
Purpose: Pain after laparoscopic cholecystectomy is less intense than after open cholecystectomy, some patients still experience considerable discomfort especially with coughing, respiratory movements and mobilization during initial few hours after surgery or during night after surgery. Material and Methods: Study included 200 patients who underwent laparoscopic cholecystectomy. They were divided into two groups of 100 patients each. One group (experimental) received bupivacaine and other group (Control) received 30 ml of normal saline after completion pf laparoscopic cholecystectomy. Results: Mean time of requirement of rescue analgesia in experimental group was 8.5 hours, whereas mean time of requirement of rescue analgesia in controls was 7.29 hrs. Total consumption of diclofenac in cases was 95mg whereas in controls it was 108.75mg (p=0.246), while as total consumption of tramadol in cases was 50 mg, whereas in controls it was 130mg (p<0.05). Postoperative abdominal pain as w...
Acta Chirurgica Belgica, 2014
Background : The aim of this randomized controlled study was to compare the postoperative analgesic efficacy of intraperitoneal bupivacaine versus levobupivacaine in patients undergoing laparoscopic cholecystectomy. Methods : We randomly divided 90 patients undergoing elective laparoscopic cholecystectomy into 3 groups. A dose of 0.125% bupivacaine (Group B) 80 ml or 0.125% levobupivacaine (Group L) 80 ml or 0.09% NaCl (Group P) 80 ml was instilled intraperitoneally at the end of the procedure, before removal of the trocars. All patients had a standard anesthetic. Tramadol was administered intravenously via a patient controlled analgesia pump as a rescue analgesic in all patients. Postoperative pain scores were assessed at 30 minutes, 1, 2, 4, 6,12 and 24 hours after surgery by using a visual analog scale. The primary end point of this study was to compare tramadol consumption of the three groups at the postoperative 24 h. Total tramadol consumption, first analgesic requirement time and adverse effects were recorded. Results : Group B experienced significantly less pain (P < 0.01) than the placebo group at 6 h, 12 h and 24 h post operatively during rest. Group L registered significantly lower visual analog scale scores (p < 0.01) than the placebo group at 12 h during rest. During movement, visual analog scale pain scores were lower in group B than Group P (P < 0.01). Additionally, total tramadol consumption was significantly lower in Group B than the other groups. First analgesic requirement time was shorter in the placebo group compared with group B and group L (P < 0.05). There was no significant difference between the groups with respect to right shoulder pain, total nausea and vomiting. Conclusion : Intraperitoneal instillation of bupivacaine 0.125% 80 ml (100 mg) is more effective than levobupivacaine 0.125% 80 ml (100 mg) in reducing the postoperative pain after laparoscopic cholecystectomy.
Intraperitoneal bupivacaine does not attenuate pain following laparoscopic cholecystectomy
JSLS: Journal of the …, 2000
Background: Laparoscopic cholecystectomy is characterized by a short hospital stay. Hence, pain control on the day of surgery is increasingly important. The aim of this study was to evaluate the effect of intraperitoneal bupivacaine on pain relief following laparoscopic cholecystectomy. Methods: Sixty patients undergoing elective laparoscopic cholecystectomy were prospectively randomized into 2 groups. Following removal of the gallbladder, group A received 100 mg of bupivacaine in 50 cc of saline, installed into the gallbladder bed and right subphrenic space. Group B received saline without bupivacaine. Pain was assessed using a visual/analog scale at fixed-time intervals. Results: No significant difference occurred in the average pain levels between the groups at 1, 2, 4, and 14 hours postsurgery. The average analgesic requirement was lower in the bupivacaine group, but this did not reach statistical significance. Conclusion: Application of intraperitoneal bupivacaine did not attenuate pain following laparoscopic cholecystectomy, and no role exists for its routine use.