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COMPARISON BETWEEN EFFICACY AND SAFETY OF DICLOFENAC SODIUM SUPPOSITORY AND INTRAPERITONEAL BUPIVACAINE IN REDUCING PAIN AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Dr Mudassar Murtaza, Dr Mohammad Ansar Aslam, Dr Mumtaz Ali

Introduction: Over the years, the intraperitoneal analgesic pathway has been studied for effective pain relief after laparoscopic cholecystectomy, but there are conflicting reports of its use. Objective: This study was conducted to compare the safety and efficacy of postoperative analgesic, diclofenac 100 mg per rectal and 10 ml 0.125% intraperitoneal bupivacaine in patients planned for laparoscopic cholecystectomy. Place and Duration: In the Surgical Unit II and Anesthesia department of Govt Teaching Hospital Shahdara Lahore for one year duration from February 2019 to February 2020. Methods: 80 patients who underwent laparoscopic cholecystectomy were divided randomly into 2 groups. There were 55 males and 25 females. The intraperitoneal bupivacaine was given in group I and diclofenac suppository was given in group II, 40 patients in each group. After the start of the operation, patients in Group I were subjected to 10 ml of infiltration with 0.125% bupivacaine from the cannula after removal of the laparoscope. Meanwhile, patients in group II received 100 mg of diclofenac suppository. Results: In group II; Ingestion of rescue analgesics was significantly greater. Rescue analgesics were required in 18 subjects in Group II, and postoperative only in 3 subjects in Group I. In both groups; mean pain score (PAVS) for 6 hours was statistically analyzed. In group I; the patient’s pain scores were considerably lesser than in group II. (P value 0.0001) Conclusion: The10 ml intraperitoneal administration of 0.125% bupivacaine is effective and safe method for relief of pain postoperatively after laparoscopic cholecystectomy. Keywords: laparoscopic cholecystectomy, treatment of postoperative pain, local anesthesia, intraperitoneal instillation, comparison, bupivacaine.