Effect Evaluation of Intraperitoneal Injection of Bupivacaine on Postoperative Pain in Laparascopic Cholecyctectomy

Document Type : Original Article

Authors

1 Department of Anesthesiologist, Toxicology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Deparment of Anesthesiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Deparment of Surgeon, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Abstract

Background and Objectives: Laparoscopic cholecyctectomy is the choice procedure for acute cholecystitis. The post-operative pain is first feel when the opioids affect are diminisehd and become very severe in first 24h after surgery. The aim of this study was to assess the efficacy of intraperitoneal bupivacaine on reduction of pain intensity in patients underwent   laparoscopic cholecyctectomy.
Subjects and Methods:In this study,60 patients(20-60y) underwent laparoscopic cholecystectomy, were divided into two case and control groups (each 30 cases). The first was administered bupivacaine (IP) in normal saline and the other with normal saline only. After local anesthesia removed, Case and control groups were assessed for pain intensity based on NRS at 0, 1, 2, 4, 8, 12, 24 hours after surgery. Data were analyzed with SPSS17 program.
Results: The mean age of case and control group was 46.7 and 46.9 y respectively.  The frequency of male and female in case group was 16.7 and 83.3%; while in control group was 30 and 70% (P=0.593). Pain intensity was significant lower in case group relative to control group at 0, 1, 2, 4, 8, 12 and 24 hr (P=0.001). The first request time for opioids and rate of using opioid after surgery were significantly different in cases and controls (P<0.01).
Conclusion: According to this finding, it seems that intraperitoneal bupivacaine is useful for pain reduction after surgery.

Keywords

References

1-Hunter JG, Jobe LA. Minimally invasive surgery, Robotics and natural orifice transluminal Endscopic syrgery. In: Schwartz's principles of surgery.9th ed. New York: McGraw-Hill; 2010. P. 359-78.
2-Miller RD, editor. Miller's Anesthesia. 7th ed. Philadelphia: Churchill livingstone/Elsevier; 2010. P. 2757-82.
3-Bisgaard T, Klarskov B, Rosenberg J, Kehlet H. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain 2001;90(3):261-9.
4-Wills VL, Hunt DR. Pain after laparoscopic cholecystectomy. Br J Surg 2000;87(3):273-84.
5-Golubovic S, Golubovic V, Cindrić-Stancin M, Tokmadzić VS. Intraperitoneal analgesia for laparoscopic cholecystectomy: bupivacaine versus bupivacaine with tramadol. Coll Antropol 2009;33(1):299-302.
6-Narchi P, Benhamou D, Fernandez H. Intraperitoneal local anaesthetic for shoulder pain after day-case laparoscopy. Lancet 1991;338:1569–70.
7-Joshi GP, Viscusi ER, Gan TJ, Minkowitz H, Cippolle M, Schuller R, et al. Effective treatment of laparoscopic cholecystectomy pain with intravenous followed by oral COX-2 specific inhibitor. Anesth Analg 2004;98(2):336-42.
8-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(4):464-71.
9-Bisgaard T, Kehlet H, Rosenberg J. Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg 2001;167(2):84-96.
10-Kehlet H. Postoperative opioid sparing to hasten recovery: What are the issues? Anesthesiology 2005;102(6):1083-5.
11-Marret E, Kurdi O, Zufferey P, Bonnet F. Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials. Anesthesiology 2005;102(6):1249-60.
12-Soltanzadeh M, Behaeen K, Pourmehdi Z. Effects of acupressure on nausea and vomiting after gynecological laparascopy. Life Sci J. 2012; 9: 871-5
13-Kehlet H, Liu SS. Continuous local anesthetic wound infusion to improve postoperative outcome: back to the periphery? Anesthesiology 2007;107(3):369-71.
14-Hanson IR, Hingson RA. The use of xylocaine, a new local anesthetic, in surgery, obstetrics and therapeutics. Curr Res Anesth Analg 1950;29(3):136-47.
15-Griffin EM, Prystowsky H, Hingson RA. The use of topical anaesthesia of the peritoneum in poor risk surgery and in augmenting inadequate vertebral conduction anaesthesia. N Z Med J 1951;50(275):31-3.
16-Ajao OG. The use of local anaesthetics for emergency abdominal operations. Trop Doct 1978;8(2):73–5.
17-La Colla L, Mangano A, Albertin A. Continuous infusion of intraperitoneal bupivacaine after laparascopic surgery: a randomized controlled trial--what about statistical power and analysis? Obes Surg 2009;19(6):817-8.
18-Papadima A, Lagoudianakis EE, Antonakis P, Filis K, Makri I, Markogiannakis H, et al. Repeated  intraperitoneal instillation of levobupivacaine for the management of pain after laparoscopic cholecystectomy. Surgery 2009;146(3):475-82.
 
 
 
 
 
 
Jundishapur Scientific Medical Journal
Volume 13, Issue 2 - Serial Number 89
July and August 2014
Pages 233-240

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History

  • Receive Date: 22 February 2012
  • Revise Date: 23 June 2012
  • Accept Date: 10 July 2012

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