LAPAROSCOPIC CHOLECYSTECTOMY

The effect of intraperitoneal instillation of bupivacaine on the mean post-operative pain scores

Abstract

Introduction: Laparoscopic cholecystectomy is the treatment of choice for
symptomatic cholelithiasis. Intraperitoneal instillation of bupivacaine is one of the methods used
to improve pain relief after laparoscopic cholecystectomy. Objective: To compare the mean pain
score after intraperitoneal instillation of bupivacaine with placebo during laparoscopic
cholecystectomy. Study Design: Randomized Control trial. Setting: This study was carried out a
surgical unit PGMI Lady Reading Hospital and Hayatabad Medical Complex, Peshawar.
Duration: The duration of study was 6 months from 15th May to 15th December, 2013. Subjects
and Methods: 92 patients in each group were included in study to compare the mean pain score
of intraperitoneal instillation of bupivacaine (Group A; study group) with 0.9% normal saline
solution (Group B; placebo group) using visual analogue scale after laparoscopic
cholecystectomy at 12th hour after surgery. Data was entered in software SPSS version 16.0. T
test was used to compare the mean pain scores. Results: The mean age of patients in Group A
and B was 41.82 ± 7.34 and 40.95 ± 9.24 respectively (p=0.483). Group A has low mean pain
score (3.619 ± 0.676) according to Visual Analogue Scale then Group B (3.837 ± 0.667) with a
statistically significant p value (p=0.036). A t test failed to reveal a statistically reliable difference
between gender (p=0.513) and age (p=0.767) wise distribution of mean pain between group A
and B. Conclusions: Mean pain score of intraperitoneal instillation of bupivacaine is significantly
less than 0.9% normal saline solution at 12th hour after laparoscopic cholecystectomy.