Evaluation of the Effect of Injection of Bupivacaine in Reducing Nausea and Vomiting after Laparoscopic Cholecystectomy Surgery

Document Type : Original Article

Authors

1 Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Department of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Abstract

Background and Objectives: Nowadays, using laparoscopic surgery, including   lower risks,is becoming more common. so patients can go home early. However, nausea and vomiting after surgery because of irritation of the diaphragm and  peritoneal  stretch is very annoying.  appropriate method of treatment is necessary to reduce nausea and vomiting after laparoscopic surgery. In this study, effectiveness of intraperitoneal administration of bupivacaine  to reduce nausea and vomiting after laparoscopic cholecystectomy surgery was assessed.
Subjects and Methods: in this randomized , double blind clinical trial 50 patients were enrolled. Patients were randomly divided into two groups. In the normal saline group, 0.5 ml/kg of 0/45% normal saline and in bupivacaine group, 0/5 mg/Kg bupivacaine 0/5% was injected into the peritoneal cavity at the end of surgery. The incidences of nausea and vomiting were compared at 1, 2, 6 and 12 hrs after surgery.
Results: Both groups were compared in terms of nausea and vomiting. Nausea decreased in bupivacaine group in 1 and 2 hours after surgery(p value =0/01). but no changes was observed at 6 and 12. no change was observed in vomiting after surgery . Conclusion:  The results of this study showed that bupivacaine is effective in reducing post-operative nausea.This drug is also easily available.It is recommended that it be used in laparoscopic cholecystectomy
 

Keywords


 
2-Stadler M, Bardiau F, Seidel L, Albert A, Boogaerts JG. Difference in risk factors for postoperative nausea and vomiting. Anesthesiology 2003;98(1):46-52.
3-Kerger H, Turan A, Kredel M, Stuckert U, Alsip N, Gan TJ, et al. Patients'' willingness to pay for anti-emetic treatment. Acta Anaesthesiol Scand 2007;51(1):38-43.

4-Miller RD,  editorp. Miller’s anesthesia. 7th ed. Philadelphia: Churchill Livingstone/ Elsevier; 2009.

5-Ku CM, Ong BC. Postoperative nausea and vomiting: a review of current literature. Singapore Med J 2003;44(7):366-74.
 6-Goodman LS, Hardman JG, Limbird LE, Gilman A, eds. Goodman & Gilman''s the pharmacological basis of therapeutics.10th ed.  New York: MC Graw_Hill, Medical; 2001. P. 879-81.
7-Thomson AJ, Shoukrey MN, Gemmell I, Abbott JA. Standardizing pneumoperitoneum for laparoscopic entry. Time, volume, or pressure: which is best? J Minim Invasive Gynecol 2012;19(2):196-200.
8-Sanei B, Moazeni Bistgani M, Reisi S. [The efficacy of dexamethasone on post-cholecystectomy nausea and vomiting]. J Kashan Univ Med Sci 2011;14(4):398-404. [In Persian]
9-Norozi A, Fateh S, Rahbari E. [The effect of gabapentin on controlling nausea and vomiting after laparoscopic cholecystectomy]. Arak Med Univ J 2012;15(4):69-75. [In Persian]
10-Wilhelm SM, Dehoorne-Smith ML, Kale-Pradhan PB. Prevention of postoperative nausea and vomiting. Ann Pharmacother 2007;41(1):68-78.
11-Safae M, Safi S. [Evaluation of effect of ondansetron on nausea and vomiting after elective cholecystectomy surgery in women older than 40 years]. J Isfahan Med School 2011;29(149):1021-7. [In Persian]
12-Alleyassin A, Khademi A, Shoeibi G, Khalili B.[ Intraperitoneal injection of Bupivacaine and Lidocaine in reducing postoperative pain in gynecologic laparoscopic surgeries:a comparative study]. Tehran Univ Med J 2007;65(4):19-23. [in Persian ]
13-Papadimitriou L, Livanios S, Katsaros G, Hassiakos D, Koussi T, Demesticha T. Prevention of postoperative nausea and vomiting after laparoscopic gynaecological surgery. Combined antiemetic treatment with tropisetron and metoclopramide vs. metoclopramide alone. Eur J Anaesthesiol 2001; 18( 9 ):615–19.