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TITLE:

COMPARISON OF EARLY POSTOPERATIVE PAIN FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY WITH AND WITHOUT PORT SITE & INTRAPERITONEAL BUPIVACAINE

AUTHORS:

Dr Muhammad Ramzan Shah, Dr Lala Rukh Bangash, Dr Qaiser Khalil, Dr Mazhar Iqbal, Muhammad Shafquat Amin

ABSTRACT:

Abstract: Objective: to compare mean early postoperative pain score with and without use of port site & intraperitoneal bupivacaine in patients undergoing laparoscopic cholecystectomy under general anaesthesia. Study Design: Randomized controlled trial Setting: Department of Anaesthesia, Mayo Hospital Lahore Duration Of Study: from April 2012 to October 2012. Material & methods: 100 patients undergoing laparoscopic cholecystectomy were randomized in two groups (50 in each). Patients in study group(Group-A) received 20ml of intraperitoneal bupivacaine 0.25% and another 20ml of 0.25% bupivacaine for infiltration at port sites(5 ml at each). No intervention was done with patients in study group (Group-B). Assessment of early postoperative pain was done at 0, 2, 4 and 6 hours and two groups were compared. Results: Mean age in the study was calculated as 39.42 ± 4.27 years in group A and 37.88 ± 4.03 years in group B. Regarding gender distribution, 18 %( n=9) in Group-A and 28 %( n=14) in Group-B were males while 82 %( n=41) in Group-A and 72 %( n=36) in Group-B were females. Mean pain score was recorded at 0, 2, 4 and 6 hours postoperatively. Mean pain score at 0 hour was 2.28 ± 0.99 in Group-A and 2.26 ± 0.98 in Group-B; p value was recorded as 0.920, which is insignificant. Similarly, there was no significant difference (p=0.068) between the groups regarding mean pain score at 2 hours which was recorded as 4.580 ± 0.57 in group A and 4.808 ± 0.80 in Group B respectively. Mean pain score at 4 hour was 4.20 ± 0.80 in group A and 5.86 ± 0.94 in group B (p=0.000) while at 6 hour it was 5.02 ± 0.91 in group A and 7.16 ± 1.36 in group B (p=0.000). Conclusion: We concluded that the use of port site and intraperitoneal bupivacaine is simple, safe, non-invasive and effective in decreasing early postoperative pain after laparoscopic cholecystectomy. Keywords: Laparoscopic cholecystectomy, early post-operative pain, bupivacaine, mean pain score.

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