TITLE:
The Effect of Intraperitoneal Ropivacaine for Post-Operative Pain Management in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective Double-Blind Randomized Control Study
AUTHORS:
Dinesh Singh, Jaishri Bogra, Sulekha Saxena, Ajay Chaudhary, Shashi Bhusan, Girish Chandra
KEYWORDS:
Intraperitoneal; Bupivacaine; Cholecystectomy; Anaesthetic
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.3,
May
24,
2013
ABSTRACT:
Objective: To
compare the effect of intraperitoneal ropivacaine with placebo for
post-operative pain management in patients undergoing laparoscopic
cholecystectomy. Material and Methods: All patients were pre-medicated with
glycopyrrolate 0.2 mg,
ondansetron 4 mg and ranitidine 150 mg intravenously half an hour prior to
induction of anesthesia. All patients were given standard general anaesthesia
with propofol (2-2.5 mg/kg), fentanyl 2 μg/kg, and
succinylcholine (2 mg/kg) to facilitate tracheal intubation. Anesthesia was
maintained with 60% N2O in oxygen with 0.5% to 1% Halothane. Group A: Patients
received 20 ml of 0.9% normal saline as placebo (n = 25). Group B: Patients received 20 ml
of 0.5% ropivacaine (n = 25). Results: The
age and sex distribution of both the groups was similar. The heart rate, systolic
& diastolic blood pressure, mean blood pressure and mean trend of SpO2 in both groups remained similar over the periods. The mean VAS varied
considerably within (between time) and between the groups (treatment) and was especially comparatively higher in
Group A at initial hours 15 min to 30 min and at end hours 12-24 hrs as compared with Group B. On an average, the frequent
dosing of rescue analgesia and mean No. of rescue analgesia doses were higher in Group A followed by Group B. In
both groups, the treatment related adverse events were mostly emetic symptoms and shoulder pain with
the highest being in Group A. Conclusion: We conclude that intraperitoneal
instillation of local anaesthetic is an easy, cheap, and non-invasive method which
provides good analgesia in the immediate postoperative period after
laparoscopic surgery.