Randomized controlled study of effectiveness and timings of bupivacaine at port site in managing pain after laparoscopic cholecystectomy

Singh, Rana Ranjit; Bansal, Dipika; Singh, Manbachan; Shah, Amip

doi:10.18203/2349-2902.isj20162888

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…Singh et al and Gabriel et al also studied similar findings. 17,31 Suryawanshi et al also taken adhesion of GB to omentum and viscus as a parameter to consider as a difficult LC. Nachnani et al, also used this criterion for considered as difficult LC.…”

Section: Perioperative Findingsmentioning

confidence: 99%

Prediction of difficult laparoscopic cholecystectomy on the basis of preoperative ultrasonography assessment

Chhaparia,

Dewangan,

Rao Geddam

2023

Int Surg J

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Background: Laparoscopic cholecystectomy (LC) is widely used for cholecystolithiasis. Abdominal ultrasonography (USG) is the investigation of choice for diagnosis of gall stone and often done before cholecystectomy. It also helps to predict possible complications during peri-operative period. Till now, there is no established definition of difficult LC. Method: Patients diagnosed as cholecystolithiasis confirmed by USG were studied. Nine parameters of abdominal USG had been assessed. Each parameter was divided into two groups, group A and group B based on finding of USG. Total number of USG finding of each group was calculated. Each surgery was assessed and categorise as easy or difficult and co related with total number of USG finding of each group. Results: For difficult LC-group B USG criteria ≥4 with group A USG criterion ≤5 having sensitivity 84.09%, specificity 80.43% and diagnostic accuracy 82.22%. For easy LC-group A USG criterion ≥6 with group B USG criteria ≤3 having sensitivity 80.43%, specificity 84.09% and diagnostic accuracy 82.22%. For easy LC, the mean post-operative stay was 1.57 days and for difficult LC, the mean post operative stay was 2.52 days. Conclusions: Preoperative USG assessment is a good predictor of difficult LC. Thick-walled gall bladder (GB), presence of pericholecystic fluid collection, impacted stone at neck or proximal to neck of GB and contracted GB are good predictors of difficult LC. Gender is not an independent risk factor for difficult LC.

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Section: Perioperative Findingsmentioning

confidence: 99%

Prediction of difficult laparoscopic cholecystectomy on the basis of preoperative ultrasonography assessment

Chhaparia,

Dewangan,

Rao Geddam

2023

Int Surg J

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“…Similar studies in our part of the world have shown some benefit. [6][7][8] However, limited studies are available which compared the pre and post-operative usage of the same analgesic. Kashmiri et al 9 at Dow University of Health Sciences compared analgesic effects of different mode of local anesthetic administration in our population.…”

Section: Introductionmentioning

confidence: 99%

Comparison Between Analgesic Effects of Pre-Operative and Post-Operative Trocar Site Infiltration of Injection Bupivacaine in Elective Laparoscopic Cholecystectomy

Akhtar,

Hussain

et al. 2023

PAFMJ

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Objective: To compare the analgesic efficacy of Local Anaesthetic infiltration with Bupivacaine at Trocar site in Laporoscopic Cholecystectomy when injected preoperatively vs postoperatively. Study Design: Quasi-experimental study. Place and Duration of Study: Department of General surgery, Combined Military Hospital, Rawalpindi Pakistan, from May to Nov, 2016. Patients and Methodology: Patients meeting the inclusion criteria were randomly divided into two groups using coin method. Group A received pre-operative injection of Bupivacaine infiltrated at the trocar sites. Patients in Group B received the similar dosage post-operatively. The pain of the patients was assessed post-operatively using Visual Analog Score (VAS) at 6, 12 and 24 hours and compared. Results: A total of 190 patients were equally divided into Group A and B (95 each). The mean age was 46±13.77 years in Group A and 43±14.80 years in Group B.23.68% (n=45) of patients were aged between 12-24 years, 13.15% (n=25) were of 25-36 years, 22.63% (n=43) were aged 37-48 years and 40.52% (n=77) of the patients were between the age of 49-60 years. 75.78% (n=144) of patients were males, while 24.21% (n=46) were females. The Mean±SD VAS post-operative pain scoring Group A and Group B was 4.5±0.04 vs 5.0± 0.40, respectively. The p-value was <0.001and the difference is statically significant. Conclusion: We concluded that the use of pre-operative local anesthesia helps reduce post-operative pain in patients undergoing laparoscopic cholecystectomy.

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“…Local anaesthetic like bupivacaine has a half-life of 2.5 to 3.5 hours and has been reported to provide pain control for an average of 5 hours. 1 . The margin of safety of the local anaesthetic need for anesthesia is wide 2 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of dexamethasone with local anaesthetic versus local anaesthetic for laparoscopic port infiltration to assess effectiveness for post-operative analgesia

Hoque¹,

Shadia²,

Hossain³

2022

Int. J. Frontline Res. Chem. Pharm.

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Early postoperative pain remains the most prevalent complaint after any surgery. Beside conventional IV analgesic medications, subcutaneous infiltration has been established as a reliable pain relief technique. Addition of dexamethasone to local anaesthetic (example: bupivacaine, lidocaine) can also be used as it has some beneficial effect than use of bupivacaine only. The objectives of this study to evaluate the duration of analgesic effects of dexamethasone with local anaesthetic as compared to local anaesthetic in post operative patient. This Randomized controlled trial study was conducted among 60 patients who underwent Laparoscopic cholecystectomy. This study was conducted from January,2019 to June,2019. All patients who underwent laparoscopic cholecystectomy surgery were selected by purposive sampling. Data were compiled, edited, analyzed. The SPSS version 23 was used for data analysis. In this study distributing the patient in demographic changes, age, sex, BMI do not show any significant change. Most Group 2 patients have long analgesia effect (NRS score more than 5), delay requirement of first rescue analgesia. NRS (Numerical Rating Scale) score in Group 2 were persistently lower than that of Group 1. This revealed that combination of Bupivacaine and Dexamethasone is quite effective in reducing postoperative port site pain in comparison to Bupivacaine (P=<0.001).

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Randomized controlled study of effectiveness and timings of bupivacaine at port site in managing pain after laparoscopic cholecystectomy

Cited by 6 publications

References 13 publications

Prediction of difficult laparoscopic cholecystectomy on the basis of preoperative ultrasonography assessment

Prediction of difficult laparoscopic cholecystectomy on the basis of preoperative ultrasonography assessment

Comparison Between Analgesic Effects of Pre-Operative and Post-Operative Trocar Site Infiltration of Injection Bupivacaine in Elective Laparoscopic Cholecystectomy

Comparison of dexamethasone with local anaesthetic versus local anaesthetic for laparoscopic port infiltration to assess effectiveness for post-operative analgesia

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