A comparative study on postoperative pain relief in laparoscopic cholecystectomy: Intraperitoneal bupivacaine versus combination of bupivacaine and buprenorphine

Khurana, Sandeep; Garg, Kamakshi; Grewal, Anju; Kaul, Tej K; Bose, Abhishek

doi:10.4103/0259-1162.164731

Cited by 17 publications

(5 citation statements)

References 15 publications

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“…Furthermore, various methods have been studied to reduce PONV in these patients (34). Similar to our findings, Khurana et al reported that intraperitoneal bupivacaine reduced pain in the first 24 hours after surgery compared with the placebo group (35). Sharma et al also reported that intraperitoneal bupivacaine and ropivacaine resulted in pain relief in the first 24 hours after surgery (18).…”

Section: Discussionsupporting

confidence: 85%

Comparison of Intraperitoneal Bupivacaine and Intravenous Ketorolac for Postoperative Pain Management Following Laparoscopic Cholecystectomy

et al. 2021

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Background: Postoperative pain following laparoscopic cholecystectomy (LC) arises from incision sites and residual intraperitoneal CO2 gas. Opioids as a class of pain-relieving drugs are broadly used to control pain after LC; however, these drugs can cause various side effects. Objectives: The purpose of this study was to compare the efficacy of intraperitoneal injection of bupivacaine with that of intravenous ketorolac in managing postoperative pain in patients who had undergone LC. Methods: This randomized, double-blind clinical trial was carried out on patients who had undergone LC. Ninety patients who had undergone elective LC were randomly divided into 3 groups (n = 30 for each group). Group A received 40 mL of 0.25% bupivacaine solution intraperitoneally at the end of the operation; group B received 30 mg of ketorolac intravenously 30 minutes before surgery and every 8 hours after surgery, and patients in group C received normal saline intraperitoneally and intravenous injection. The patients were postoperatively assessed for Visual Analog Scale (VAS) scores, postoperative opioid consumption, shoulder pain, side effects (sedation, nausea, and vomiting), and satisfaction. The data were analyzed using SPSS. P values < 0.05 were considered significant. Results: The intraperitoneal injection of bupivacaine and intravenous injection of ketorolac were significantly effective in reducing postoperative abdominal pain, shoulder pain, and incidence of nausea and vomiting compared to the placebo group (P < 0.001). Although intraperitoneal bupivacaine and intravenous ketorolac had no significant difference in pain relief compared with each other, patients in both bupivacaine and ketorolac groups were significantly more satisfied with their analgesia compared to the control group (P < 0.001). Conclusions: Intraperitoneal injection of bupivacaine and intravenous injection of ketorolac both are safe and effective methods to control pain, nausea, and vomiting after LC.

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Section: Discussionsupporting

confidence: 85%

Comparison of Intraperitoneal Bupivacaine and Intravenous Ketorolac for Postoperative Pain Management Following Laparoscopic Cholecystectomy

et al. 2021

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“…This was similar to other investigations. 9,15,[17][18][19] Raetzell et al compared bupivacaine (0.125 % and 0.25 %) to normal saline and found no difference in pain scores between the groups, 20 which could be related to the lower concentration of bupivacaine utilised. Choi et al reviewed 39 random control trial reviews and concluded that intraperitoneal local anaesthetics did not significantly diminish parietal pain but had a favourable analgesic impact on visceral pain and shoulder pain.…”

Section: Discussionmentioning

confidence: 99%

Assesment of Postoperative Analgesic Effects of Intramuscular Tramadol Administration and Intraperitoneal Bupivacaine following Laparoscopic Cholecystectomy

Griddaluru S,

Kuraparthy,

Vembuluru

et al. 2023

PMJUA

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Background: For postoperative pain relief after laparoscopic surgeries, intramuscular or intravenous non-steroidal anti-inflammatory drugs and opioids, infiltration at the incision site with local anesthetics, intraperitoneal infiltration of local anesthetics with adjuvants, epidurals and nerve blocks were in use. The study was aimed to assess the efficacy of intramuscular Tramadol and intraperitoneal instillation of bupivacaine on postoperative analgesia, postoperative nausea, and vomiting following laparoscopic cholecystectomy. Methods: This study included 60 American Society of Anesthesiologists (ASA) I and ASA II patients of aged 18-60 years who were scheduled for laparoscopic cholecystectomy under general anesthesia. 60 patients were classified randomly into two groups equally: Group T received 100 Mg of intramuscular tramadol and Group B received intraperitoneal instillation of 30 ml of plain bupivacaine. Time duration, postoperative pain, haemodynamics, nausea, vomiting, and time taken to rescue analgesia were noted. Results: The time for onset of analgesia was 6.51 ± 2.41min in group T and 7.61 ± 2.19 min in group B (p=0.039). The duration of analgesia was 2.37 ± 0.67 hours in group T and 3.65 ± 0.79 hours in group B (p=0.002). VAS Score was significantly lower in Group T than Group B at 1hr, 2hr, 4hr and 6hr (p <0.05). Intraperitoneal bupivacaine showed a significant reduction in postoperative pain for the first 6 hours postoperatively (P<0.05), and time taken to rescue analgesia requirement was prolonged (P<0.05). The rescue analgesia consumption of Paracetamol was 1.5 grams in group-B and 2.5 grams in group T (P<0.05) in 24 hr post-surgery. Nausea and vomiting were observed in 2 cases, and shoulder pain in one case in group T. Conclusion: Bupivacaine is effective in reducing postoperative pain, and it prolongs the requirement time for rescue analgesia after LC surgery. It also required less consumption of rescue analgesic without fluctuations in hemodynamics

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“…[ 12 ] found that mean VRS score was lower in both the groups with significant difference between the VRS score in immediate postoperative period, 1 st h, 3 rd h, and then from 7 th h to 12 th h. The results were also supported by Khurana et al . [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal instillation of bupivacaine and ropivacaine for postoperative analgesia in laparoscopic cholecystectomy

et al. 2018

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Background:Intraperitoneal instillation of local anesthetics in laparoscopic cholecystectomy (LC) has been used to reduce postoperative pain and to decrease the need for postoperative analgesics.Aims:This study aimed to compare intraperitoneal instillation of bupivacaine and ropivacaine for postoperative analgesia in patients undergoing LC.Settings and Design:This was a prospective, randomized, double-blind study.Materials and Methods:After obtaining ethical committee's clearance and informed consent, sixty patients, aged 18–65 years, of either gender, and American Society of Anesthesiologists physical status I to III scheduled for LC were included and categorized into two groups (n = 30). Group A patients received 20 mL of 0.5% bupivacaine intraperitoneally after cholecystectomy and Group B patients received 20 mL of 0.5% ropivacaine intraperitoneally after cholecystectomy.Statistical Analysis:The data were analyzed using paired t-test. The results were analyzed and compared to previous studies. SPSS software version 22 was used, released 2013 (IBM Corp., Armonk, NY, USA).Results:Pulse rate, systolic blood pressure, and diastolic blood pressure were comparatively lower in Group B than in Group A. The visual analog scale (VAS) score was significantly lower in Group B. Rescue analgesia was given when VAS was >6. Verbal rating scale score was significantly lower in Group B, showing longer duration of analgesia in this group. Rescue analgesic requirement was also less in Group B.Conclusion:The instillation of bupivacaine and ropivacaine intraperitoneally was an effective method of postoperative pain relief in LC. It provided good analgesia in immediate postoperative period with ropivacaine, providing longer duration of analgesia.

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A comparative study on postoperative pain relief in laparoscopic cholecystectomy: Intraperitoneal bupivacaine versus combination of bupivacaine and buprenorphine

Cited by 17 publications

References 15 publications

Comparison of Intraperitoneal Bupivacaine and Intravenous Ketorolac for Postoperative Pain Management Following Laparoscopic Cholecystectomy

Comparison of Intraperitoneal Bupivacaine and Intravenous Ketorolac for Postoperative Pain Management Following Laparoscopic Cholecystectomy

Assesment of Postoperative Analgesic Effects of Intramuscular Tramadol Administration and Intraperitoneal Bupivacaine following Laparoscopic Cholecystectomy

Intraperitoneal instillation of bupivacaine and ropivacaine for postoperative analgesia in laparoscopic cholecystectomy

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