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Use of Intraperitoneal and Port Site Infiltration of Bupivacaine for Controlling Pain after Laparoscopic Cholecystectomy: A Prospective Study

Year 2015, Volume: 40 Issue: 4, 692 - 697, 02.10.2015
https://doi.org/10.17826/cutf.16046

Abstract

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 well as shoulder tip pain were less at all-time intervals (4h, 12h, and 24h) in cases compared to controls. Only 2 patients developed bradycardia and 1 patient developed mild drowsiness in experimental group in post-operative period. All the 3 patients required only monitoring and settled in 3-4 hours. Mean hospital stay in experimental group was 1.71 days, whereas in controls it was 1.93 days. Conclusion: Intraperitoneal and port site bupivacaine significantly reduces both somatic and visceral components of pain in post-operative period in laparoscopic cholecystectomy. It decreases the requirement of rescue analgesia and expedites discharge of patient from hospital.

References

  • Brett M, Baker DJ. World distribution of gall stones. Int J Epidemiol. 1976;5:335.
  • Brasca A, Berli D, Pezzotto SM. Morphological and demographic associations of biliary symptoms in subjects with gallstones: findings from a population- based survey in Rosario, Argentina. Dig Liver Dis. 2002;34:577-81.
  • Graves HA, Jeanne F, William JA. Appraisal of laparoscopic cholecystectomy. Annals of Surgery. 1991;213:655-64.
  • Saleh M, Salamah AL. Outcome of laparoscopic cholecystectomy in acute cholecystitis. JCPSP. 2005;15:400-3.
  • Ji W, Ding K, Li LT, Wang D, Li N, Li JS. Outpatient versus inpatient laparoscopic cholecystectomy: A single center clinical analysis. Hepatobiliary Pancreat Dis Int. 2010;9:604.
  • Joris J, Cigarini I, Legrand M, et al. Metabolic and respiratory changes after cholecystectomy performed via laparotomy or laparoscopy. Br J Anaesth. 1992;69:341-5.
  • Joris J, Thiry E, Paris P, Weerts J, Lamy M. Pain after laparoscopic cholecystectomy: characteristics and effect of intraperitoneal bupivacaine. Anesth Analg. 1995;81:379-84. Coelioscopie ambulatoire. Cah Anesthesiol. 1993;41:385-91.
  • Jakson SA, Laurence AS, Hill JC. Does post- laparoscopy Pain relate to residual carbondioxide? Anaesthesia. 1996;8:441-5.
  • Kum CK, Wong CW, Goh PM, Ti TK. Comparative study of pain level and analgesic requirement after laparoscopic and open cholecystectomy. Surg Laparosc Endosc. 1994;4:139-41.
  • Dath D, Park AK. Randomized, controlled trial of bupiva-caine injection to decrease pain after laparoscopic cholecystectomy. Can J Surg. 1999;42:284–8.
  • Forani M, Miglietta C, Di Gioia S, Garrone C, Morino M. The use of intraoperative topical bupivacaine in the control of postoperative pain following laparoscopic cholecystectomy. 1996;51:881–5. Minerva Chir.
  • Ure BM, Troidl H, Spangenberger W, et al. Preincisional local anaesthesia with bupivacaine and pain after laparoscopic cholecystectomy. A double- blind randomized clinical trial. Surg Endosc. 1993;7:482-8.
  • Tsimoyiannis EC, Glantzounis G, Lekkas ET, Siakas P, Jabarin M, Tzourou H. Intraperitoneal normal saline and bupivacaine infusion for reduction of postoperative pain after laparoscopic cholecystectomy. 1998;8:416-20.
  • Wallace DH, Serpell MG, Baxter JN, O'Dwyer PJ. Randomized trial of different insufflation pressures for laparoscopic cholecystectomy. 1997;84:455-8. Br J Surg.

Laparoskopik Kolesistektomi Sonrası Ağrı Kontrolü için Bupivakainin İntraperitoneal ve Port Alanı İnfiltrasyonunun Kullanımı: Prospektif Çalışma

Year 2015, Volume: 40 Issue: 4, 692 - 697, 02.10.2015
https://doi.org/10.17826/cutf.16046

Abstract

Amaç: Laparoskopik kolesistektomi sonrası ağrının, açık kolesistektomiden daha az yoğun olduğu, cerrahi sonrası ya da ameliyat sonrası gece boyunca ilk birkaç saat özellikle öksürük, solunum hareketleri ve mobilizasyonun bazı hastalarda halen önemli bir rahatsızlık olduğu görüldü. Materyal ve Metod: Çalışma laparoskopik kolesistektomi olan 200 hastayı içerdi. Her biri 100 hasta olan 2 gruba ayrıldı. Tamamlama pf laparoskopik kolesistektomi sonrası ilk gruba (deney grubu) bupivakain ve diğer gruba (kontrol grubu) 30 ml serum fizyolojik verildi. Bulgular: Kurtarma analjezi gereksiniminin ortalama süresi deney grubunda 8,5 saatken, kontrol grubunda bu süre 7,29 saattir. Deney grubunda diklofenakın toplam tüketimi 95mg iken, kontrollerde 108.75 mg'dır (p=0.246). Deney grubunda tramadolun toplam tüketimi 50mg, kontrol grubunda 130mg'dır (p<0.05). Ameliyat sonrası karın ağrısıyla birlikte omuz ucu ağrısı tüm zaman aralıklarında (4 saat, 12 saat, 24 saat) kontrollerle karşılaştırıldı. Deney grubunda ağrı daha azdı. Ameliyat sonrası dönemde deney grubunda sadece 2 hastada bradikardi ve 1 hastada hafif uyuşukluk gelişti. Bu 3 hastanın sadece 3-4 saat sürekli izlenmesi istendi. Hastanede ortalama yatış kontrollerde 1.93 gün iken, deneylerde 1.71 gündü. Sonuç: İntraperitoneal ve port alanı bupivakain, laparoskopik kolesistektomi ameliyatı sonrası dönemde ağrının somatik ve visseral bileşenlerini azaltır. Bu, kurtarma analjezi gereksinimini ve hastanın hastaneden taburcu olma hızını azaltır.

References

  • Brett M, Baker DJ. World distribution of gall stones. Int J Epidemiol. 1976;5:335.
  • Brasca A, Berli D, Pezzotto SM. Morphological and demographic associations of biliary symptoms in subjects with gallstones: findings from a population- based survey in Rosario, Argentina. Dig Liver Dis. 2002;34:577-81.
  • Graves HA, Jeanne F, William JA. Appraisal of laparoscopic cholecystectomy. Annals of Surgery. 1991;213:655-64.
  • Saleh M, Salamah AL. Outcome of laparoscopic cholecystectomy in acute cholecystitis. JCPSP. 2005;15:400-3.
  • Ji W, Ding K, Li LT, Wang D, Li N, Li JS. Outpatient versus inpatient laparoscopic cholecystectomy: A single center clinical analysis. Hepatobiliary Pancreat Dis Int. 2010;9:604.
  • Joris J, Cigarini I, Legrand M, et al. Metabolic and respiratory changes after cholecystectomy performed via laparotomy or laparoscopy. Br J Anaesth. 1992;69:341-5.
  • Joris J, Thiry E, Paris P, Weerts J, Lamy M. Pain after laparoscopic cholecystectomy: characteristics and effect of intraperitoneal bupivacaine. Anesth Analg. 1995;81:379-84. Coelioscopie ambulatoire. Cah Anesthesiol. 1993;41:385-91.
  • Jakson SA, Laurence AS, Hill JC. Does post- laparoscopy Pain relate to residual carbondioxide? Anaesthesia. 1996;8:441-5.
  • Kum CK, Wong CW, Goh PM, Ti TK. Comparative study of pain level and analgesic requirement after laparoscopic and open cholecystectomy. Surg Laparosc Endosc. 1994;4:139-41.
  • Dath D, Park AK. Randomized, controlled trial of bupiva-caine injection to decrease pain after laparoscopic cholecystectomy. Can J Surg. 1999;42:284–8.
  • Forani M, Miglietta C, Di Gioia S, Garrone C, Morino M. The use of intraoperative topical bupivacaine in the control of postoperative pain following laparoscopic cholecystectomy. 1996;51:881–5. Minerva Chir.
  • Ure BM, Troidl H, Spangenberger W, et al. Preincisional local anaesthesia with bupivacaine and pain after laparoscopic cholecystectomy. A double- blind randomized clinical trial. Surg Endosc. 1993;7:482-8.
  • Tsimoyiannis EC, Glantzounis G, Lekkas ET, Siakas P, Jabarin M, Tzourou H. Intraperitoneal normal saline and bupivacaine infusion for reduction of postoperative pain after laparoscopic cholecystectomy. 1998;8:416-20.
  • Wallace DH, Serpell MG, Baxter JN, O'Dwyer PJ. Randomized trial of different insufflation pressures for laparoscopic cholecystectomy. 1997;84:455-8. Br J Surg.
There are 14 citations in total.

Details

Primary Language English
Journal Section Research
Authors

Ubaid Ali This is me

Hanief Dar This is me

Mir Ahmed This is me

Nazir Salroo This is me

Shah Arjmand This is me

Sheikh Imran This is me

Publication Date October 2, 2015
Published in Issue Year 2015 Volume: 40 Issue: 4

Cite

MLA Ali, Ubaid et al. “Use of Intraperitoneal and Port Site Infiltration of Bupivacaine for Controlling Pain After Laparoscopic Cholecystectomy: A Prospective Study”. Cukurova Medical Journal, vol. 40, no. 4, 2015, pp. 692-7, doi:10.17826/cutf.16046.