Comparison of Bupivacaine injection versus normal saline in port sites & intraperitoneal spray for postoperative pain in laparoscopic cholecystectomy.

Abstract

Objective: To compare mean pain using bupivacaine injection versus normal saline in port sites & intraperitoneal spray in laparoscopic cholecystectomy. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesia, Shaikh Zayed Hospital, Lahore. Period: October 2, 2018 to April 2, 2019. Material & Methods: Laparoscopic cholecystectomy patients were allocated to obtain either bupivacaine 0.25% or regular saline (N / S) randomly by lottery method. In bupivacaine group-A, 15ml 8of 0.25% bupivacaine spray on gall bladder bed, dissection surface and in ports area after surgery. In normal saline group-B received 15 ml of normal saline in the same area and ports after surgery. Pain was measured on VAS as per operational definition. All the data was entered with SPSS v25.0 and analyzed. A t-test study was used to evaluate the mean pain for both groups at 24th hours. In order to address the effect modifiers, the data was stratified for age, gender, and BMI (obese, non-obese). The independent t-test sample after stratification was used taking p-value 0.05 as relevant. Results: A total of 60 patients were included for elective laparoscopic cholecystectomy. In group-A, mean pain score was 3.33±0.81 and 4.37±1.16 in group-B, which is statistically significant with a p-value of 0.0002. Conclusion: This study demonstrates that bupivacaine spray at the surgical bed and in ports site in elective laparoscopic cholecystectomy result in significant lowering of the intensity of postoperative abdominal and shoulder pain.