Role of intra operative esmolol infusion in post operative pain relief after laparoscopic cholecystectomy

Abstract

Postoperative pain following laparoscopic cholecystectomy is one of the main causes for lengthening the period of hospitalization. In an attempt to decrease this early postoperative complication, esmolol infusion was administered during general anaesthesia to patients undergoing laparoscopic cholecystectomy. Sixty patients ASA class I undergoing laparoscopic cholecystectomy were randomly assigned to two groups, esmolol group (Group E, n=30) and placebo group (Group P, n=30). In group E, patients received 1mg/kg esmolol bolus dose i.v immediately before induction while as group P received same volume of inj. Ringer Lactate as placebo. In group E, immediately after intubation, esmolol infusion was started at the rate of 5-10 µg/kg/min. The rate was titrated to maintain heart rate between 65-75 beats per min. Patients in group P received 100 ml of Ringer Lactate infusion. The incidence of PONV and pain were assessed after surgery. Incidence of postoperative analgesia requirement was significantly less in esmolol group. 50% of patients required analgesia in group E, while 83.33% required analgesia in group P (p=0.006). Post operative antiemetic requirements were also significantly less in group E. It was concluded that incidence of postoperative analgesia requirements over first 24 hours after laparoscopic cholecystectomy was found to be less in esmolol group as compared to placebo group.