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

Abstract

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.

Thirty-Day Unplanned Readmission After Ambulatory Laparoscopic Cholecystectomy in Western China: A Retrospective Study

“…It was similar to the result from Rosero and Joshi [14], who found that 11.8% unplanned readmission patients had the complaint of wound pain. Rahimzadeh et al [25] and Sharan et al [26] injected ropivacaine or bupivacaine in the Trocar site to reduce post-operative wound pain. Hamad et al [27] combined adrenaline and bupivacaine to inject in all ports to reduce the post-operative pain.…”

Application of Negative Pressure Wound Therapy with Instillation and Dwell Time of the Open Abdomen: Initial Experience

“…While many studies have been conducted with regards to their use in this context, the benefits of adding antibiotic solutions to the septic abdominal cavity remain unclear, and its pharmacological-clinical effectiveness remains unknown [22]. Other types of solutions such as anesthetics, more commonly, bupivacaine, have been utilized as post-surgical analgesia with varying levels of success [23-24]. Hypochlorous acid is also utilized as an instillation fluid to reduce abdominal fluid viscosity, thus increasing the removal of inflammatory ascites and septic material in the abdominal cavity [25].…”

Intraperitoneal ropivacaine for post-operative pain following laparoscopic tubal ligation: a randomised double-blind placebo-controlled trial

“…Examples of some intraperitoneally used local analgesics are lignocaine [19,20], bupivacaine [21] meperidine [22], and recently, ropivacaine [23][24][25][26][27]. The latter has demonstrated a superior cardioprotective effect compared to bupivacaine [28][29][30], while providing longer pain relief and reducing opioid usage [31][32][33].…”