No abstract

Introduction : Postoperative pain is variable in intensity,character,duration and is the main factor delaying discharge of patients undergoing day-care procedures including laparoscopy and hence adding to hospital cost and stay. Optimal management has a potential for shortening of hospital stay and for speeding up of recovery.AIM :Comparing the effect of port site and intraperitoneal instillation of 0.5% bupivacaine with adrenaline versus saline for post-operative analgesia in laparoscopic cholecystectomy. To assess the need of rescue analgesics in post- operative period in both groups.Material & Method :A comparative study to be performed on 50 cases receive 40 mls of 0.5% bupivacaine as intraperitoneal infiltration and local infiltration of 20 mls of 0.5% bupivacaine in the port sites (5 ml infiltration in each port) versus 50 cases receive 40 ml of normal saline intraperitoneally Discussion :Reduction in post-operative pain with better cosmesis and early return to work have been the goals to improve cost effectiveness and patient satisfaction. Conclusion : We conclude that instillation of local anaesthetic drug intraperitonialy & Port site local anaesthetic agent injection has added benefits in post operative pain

Free gas under diaphragm is a very significant X-ray finding seen among patients of acute abdomen coming to the ER of any hospital. This finding usually suggests perforation of a hollow viscus and requires urgent surgical intervention. But there are some pathologies which mimic this important sign thereby necessitating the surgeon to always take a holistic view and approach any potential laparotomy with clinical suspicion. We have presented such a case seen in our emergency department wherein an internal herniation of bowel loops presented with pseudopneumoperitoneum.