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
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