POSTOPERATIVE PAIN SCORE USING INTRAPERITONEAL LOCAL ANESTHETIC BUPIVACAINE VERSUS PLACEBO AFTER LAPAROSCOPIC CHOLECYSTECTOMY: A RANDOMIZED CONTROL TRIAL

Ali Naqi Zaidi, Lajpat Rai, Gotam Kumar, Ghina Awais, Asma Hirani, Abdullah Irshad

Abstract


Background: Intraperitoneal injection of bupivacaine has been used for treatment of pain following laparoscopic surgeries. The objective of this study was to compare the pain score using intraperitoneal local anesthetic bupivacaine versus placebo after laparoscopic cholecystectomy at 1, 6, 12, 18 and 24 hours respectively.

Materials & Methods: This randomized control trial was conducted in Department of General Surgery, Indus Hospital Karachi, Pakistan from July 2020 to January 2021. All adult patients undergoing laparoscopic cholecystectomy were eligible. Sixty patients were randomly allocated to experimental (bupivacaine=30) and placebo (normal saline=30) groups. At the end of surgery, 20 ml bupivacaine 0.5% in experimental group and 20 ml normal saline in placebo group were administered in gall bladder fossa. Postoperative pain was measured by 11-points Visual Analogue Scale at 1, 6, 12, 18 and 24 hours as five research variables. All hypotheses were verified by independent samples t-test.

Results: Experimental group included 5 (16.67%) men and 25 women (83.33%). Placebo group included 3 (10%) men and 27 women (90%). Each group included 14 (46.67%) patients in age group 19-40 and 16 (53.33%) in age group 41-65 years. Mean pain score was similar in experimental and placebo groups at 1 hour (3.63 vs. 3.87), 6 hours (3.87 vs. 4.10), 12 hours (3.53 vs. 3.37), 18 hours (2.50 vs. 2.77) and 24 hours (1.80 vs. 2.00) respectively.

Conclusion: Mean postoperative pain scores using intraperitoneal local anesthetic bupivacaine versus placebo after laparoscopic cholecystectomy at 1, 6, 12, 18 and 24 hours respectively were similar.

 


Keywords


Cholecystectomy; Laparoscopic Cholecystectomy; Postoperative Pain; Bupivacaine; Normal Saline; Peritoneum.

Full Text:

PDF

References


Choi GJ, Kang H, Baek CW, Jung YH, Kim DR. Effect of intraperitoneal local anesthetic on pain characteristics after laparoscopic cholecystectomy. World J Gastroenterol 2015;21(47):13386-95.7. https://doi.org/10.3748/wjg.v21.i47.13386

Szem JW, Hydo L, Barie PS. A double-blinded evaluation of intraperitoneal bupivacaine vs saline for the reduction of postoperative pain and nausea after laparoscopic cholecystectomy. Surg Endosc 1996;10(1):44-8. https://doi.org/10.1007/s004649910011

Papagiannopoulou P, Argiriadou H, Georgiou M, Papaziogas B, Sfyra E, Kanakoudis F. Preincisional local infiltration of levobupivacaine vs ropivacaine for pain control after laparoscopic cholecystectomy. Surg Endosc 2003;17(12):1961-4. https://doi.org/10.1007/s00464-002-9256-1

Das NT, Deshpande C. Effects of intraperitoneal local anaesthetics bupivacaine and ropivacaine versus placebo on postoperative pain after laparoscopic cholecystectomy: a randomised double blind study. J Clin Diagn Res 2017;11(7):UC08-UC12. https://doi.org/10.7860/JCDR/2017/26162.10188

Vijayaraghavalu S, Sekar EB. A comparative study on the postoperative analgesic effects of the intraperitoneal instillation of bupivacaine versus normal saline following laparoscopic cholecystectomy. Cureus 2021;13(3): e14151. https://doi.org/10.7759/cureus.14151

Visual analog scale. Physiopedia [accessed 2022 June 22]. Available at: https://www.physio-pedia.com/Visual_Analogue_Scale

Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. J Am Acad Orthop Surg Glob Res Rev 2018;2(3):e088. https://doi.org/10.5435/JAAOSGlobal-D-17-00088

Zar JH. Biostatistical Analysis. 5th ed. Englewood Clifts, New Jersey: Prentice-Hall, Inc. p.127.

Pegano M, Gauvreau K. Principals of Biostatistics. 2nd ed. Boston, MA, USA: Cengage Learning; 2000. p.349-52.

IBM SPSS Statistics for Windows, Version 22.0, released 2013, IBM Corp., Armonk, NY [cited 2022 Apr 10]. Available at: https://www.ibm.com/support/pages/how-cite-ibm-spss-statistics-or-earlier-versions-spss

Jensen K, Kehlet H, Lund CM. Post-operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime. Acta Anaesthesiol Scand 2007;51:464-71. https://doi.org/10.1111/j.1399-6576.2006.01251.x

Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res 2017;10:2287-98. https://doi.org/10.2147/JPR.S144066

Tsimoyiannis EC, Siakas P, Tassis A, Lekkas ET, Tzourou H, Kambili M. Intraperitoneal normal saline infusion for postoperative pain after laparoscopic cholecystectomy. World J Surg 1998;22:824-8. https://doi.org/10.1007/s002689900477

Boddy AP, Mehta S, Rhodes M. The effect of intraperitoneal local anesthesia in laparoscopic cholecystectomy: A systematic review and meta-analysis. Anesth Analg 2006;103:682-8. https://doi.org/10.1213/01.ane.0000226268.06279.5a

Kahokehr A, Sammour T, Srinivasa S, Hill AG. Systematic review and meta-analysis of intraperitoneal local anesthetic for pain reduction after laparoscopic gastric procedures. Br J Surg 2011;98:29-36. https://doi.org/10.1002/bjs.7293

Karaaslan D, Sivaci RG, Akbulut G, Dilek ON. Preemptive analgesia in laparoscopic cholecystectomy: A randomized controlled study. Pain Pract 2006;6:237-41. https://doi.org/10.1111/j.1533-2500.2006.00092.x

Barczyński M, Konturek A, Herman RM. Superiority of preemptive analgesia with intraperitoneal instillation of bupivacaine before rather than after the creation of capnoperitoneum for laparoscopic cholecystectomy: A randomized, double-blind, placebo-controlled study. Surg Endosc 2006;20:1088-93. https://doi.org/10.1007/s00464-005-0458-1




DOI: https://doi.org/10.46903/gjms/21.03.1293

Refbacks

  • There are currently no refbacks.


Copyright (c) 2023. Ali Naqi Zaidi, Lajpat Rai, Gotam Kumar, Ghina Awais, Asma Hirani, Abdullah Irshad

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Gomal Medical College, Daraban Road, Dera Ismail Khan, Pakistan

ISSN: 1819-7973, e-ISSN: 1997-2067

Website: https://www.gmcdikhan.edu.pk

Phone: +92-966-747373

Scimago Journal & Country Rank