Comparison of use of Bupivacaine and Normal Saline in Liver Bed & Ports after Laparoscopic Cholecystectomy in Postoperative Pain Reduction
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- 05 Mar, 2025
Abstract: Background: Laparoscopic cholecystectomy results in lesspost operative pain than open cholecystectomy. However post operative pain remainsan issue following the procedurewhich can prolong hospital stay and lead to increased morbidity. Objectives: Effective management of post operative pain will thus help to mobilize the patients earlier, reduce the requirement for post operative analgesic; early hospital discharge, return to normal activities & normal work. This will help to reduce the total cost related to the operation and total working days lost. Methods:In this randomized controlled trial A total of 100 patients undergoing routine laparoscopic cholecystectomy were enrolled in this study during March 2015 to May 2016 in Pabna Medical College Hospital. The patients were randomly assigned in control group and bupivacaine group. Patients of the bupivacaine group received local anesthetic agent bupivacaine at their port sites which was infiltrated in the skin, subcutaneous tissue, fascia, and liver bed at the end of the surgery. The control group received normal saline in the same manner. All the patients were followed up to assess the intensity of post operative pain using visual analogue pain scale at 4 hours, 12 hours and 24 hours of operation as well as at the time of discharge from the hospital and at one week after the operation. Data regarding the first analgesic request by the patient after surgery, total doses of analgesic consumed in the post operative period and return to normal day to day activities and the normal work were also collected. Results:Datawere analyzed using SPSS Statistics 17.0 and revealed that patients receiving bupivacaine infiltration at their port sites and liver bed following the surgery had lower pain scores at the times of assessment than those who received normal saline at their port sites. The patients of the bupivacaine group also took longer time for first request for analgesic after surgery and required less doses of analgesic. Conclusion: Infiltration of bupivacaine at port site and liver bed following laparoscopic cholecystectomy is an effective method of managing post operative pain. This also lower the doses of analgesic required, thus laparoscopic cholecystectomy can be considered as a fast - track surgery.
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