Postoperative Analgesic Efficacy of Intraperitoneal Ropivacaine in Patients Undergoing Laparoscopic Cholecystectomy
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 4
Abstract
Background- Laparoscopic cholecystectomy is one of the most commonly performed day care surgeries. Although the patients complain of less pain than the open procedures, yet the emanating visceral pain causes significant discomfort. Multimodal analgesics have been tried to alleviate this pain by various routes. Intraperitoneal administration of local anaesthetics is one such modality. Ropivacaine when used intraperitoneally provides profound and prolonged analgesia.Aim- The aim of this study was to evaluate the analgesic efficacy of intraperitoneally administered Ropivacaine in patients undergoing laparoscopic cholecystectomy. Materials and methods- Patients were randomly allocated into two groups: Group C (control group n= 50) which received 40 ml of 0.9% saline and Group R (Ropivacaine group n= 50) which received 2mg/kg of Ropivacaine made to a total of 40 ml volume. Postoperative assessment of pain was done using visual analogue scale (VAS) and at VAS>3 intravenous tramadol 1mg/kg was administered. Time to first request of analgesia, total number of rescue analgesics in 24 hours at VAS>3, the incidence and severity of postoperative shoulder pain as well as adverse effects if any were noted. Results-Both the groups control group (group C) and the Ropivacaine group (group R) were comparable with regards to demographic profile and total duration of surgery. Ropivacaine provided prolonged duration of analgesia (19.68 ± 2.48 hours) compared to the control group (6.72 ± 4.13 hours), the results being statistically highly significant (P< 0.001). Mean number of rescue analgesics in 24 hours at VAS> 3 were higher in the control group(1.9 ± 0.54) than the Ropivacaine group (0.82 ± 0.39), the difference being statistically significant (P< 0.05). The incidence of shoulder pain albeit small, was comparable in both the groups and severity ranged fromVAS 2-4. Incidence of nausea and vomiting was 10% and 20% respectively in the control group and Ropivacaine group. No other side effects were observed.Conclusion-Intraperitoneal instillation of Ropivacaine provides an effective and protracted analgesia in patients undergoing laparoscopic cholecystectomy.
Authors and Affiliations
Smriti Anand, Rakesh Sadhu, Pradeep Goyal
Keywords
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- EP ID EP370789
- DOI 10.9790/0853-1704075155.
- Views 41
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