Comparison of Preemptive Intraperitoneal Instillation and Nebulisation of 0.5% Ropivacaine in Laparoscopic Cholecystectomy for Post-operative Pain Relief
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 4
Abstract
Objective: The etiology of postoperative pain in patients undergoing laproscopic cholecystectomy is multifactorial consisting of incisional and visceral pain from the operation itself and parietal pain from trauma and irritation to the peritoneum and diaphragm. Design: This randamozied single blind study was conducted on 60 patients of either sex undergoing laproscopic cholecystectomy under general anesthesia. Group A [n=30] received 15 ml of 0.5% ropivacaine by instillation and group B [n=30] received 15 ml of 0.5% ropivacane intraperitoneally by piston type of nebulization 10 minutes before surgery and both the groups got 5 ml [0.5%] ropivacaine at the trocar site at the end of surgery. Results: Patients in both the groups were comparable with respect to age, sex and weight [p>0.05]. VAS score for incisional pain was significantly lower in Group A at 1hour and 8 hrs postoperatively [p=0.02 and p=0.04] respectively. At all other intervals the incisional pain, Visceral pain and shoulder tip pain was comparable amongst the two groups [p>0.05]. Time to first analgesia was longer in group A [2.29 hrs] as compared to Group B [1.66 hrs] but was stastically insignifiacant [p>0.5]. Mean total number of analgesic used was 1.4 in both the groups [p=1]. Conclusion: Intraoperative subdiaphgramatic and intraperitoneal instillation of ropivacaine 0.5% is beneficial and better modality of pain relief because of ease of technique and better VAS scores as compared to intrperitoneal nebulization of ropivacaine.
Authors and Affiliations
Jyoti Pathania
A Comparative Evaluation of the Efficacy of Dexmedetomidine versus Fentanyl as Anesthetic Adjuvant in Attenuating the Neuroendocrine Stress Response, as Assessed Indirectly, during Laparoscopic Cholecystectomy
Background and Aims: Hyperglycemia and hemodynamic perturbations are the main features of neuroendocrine stress response to surgical trauma and anesthesia. We conducted a study to evaluate and compare dexmedetomidine an...
Comparative Study of LMA Supreme versus I-gel in Patients Undergoing Laparoscopic Surgeries with Positive Pressure Ventilation
Backround: The main objective of this study is to compare the efficacy of two newer supraglottic airway devices LMA Supreme and I GEL in patients undergoing laparoscopic surgeries with positive pressure ventilation. Mate...
Efficacy of USG-Guided Bilateral Subcostal Tranversus Abdominis Plane Block and Conventional Port Site Infiltration after Laparoscopic Cholecystectomy: A Prospective Randomised Controlled Study
Aim and objectives: This prospective, randomised, single blinded controlled study evaluated and compared the efficacy of Bilateral subcostal USG- guided Transversus Abdominis muscle plane block to the Conventional Port s...
Efficacy of Cisatracurium over Atracurium in Patients undergoing Lower Abdominal Surgeries at a Tertiary Care Hospital
Context: Atracurium is associated with hemodynamic instability in patients. Cisatracurium has been developed to overcome this side effect which is an isomer of atracurium. Aim: To study the efficacy of Cisatracurium in p...
Modified Transversus Abdominis Plane (TAP) Block for Postoperative Analgesia Following Cesarean Delivery
Adequate postoperative pain relief after Caesarean delivery (CD) improves ambulation, breastfeeding and infant weight gain. The analgesic efficacy of the TAP block has been confirmed and used for postoperative analgesia...