The Effect of Intraperitoneal Ropivacaine for Post-Operative Pain Management in Patients Undergoing Laparoscopic Cholecystectomy: A Prospective Double-Blind Randomized Control Study

Dinesh Singh, Jaishri Bogra, Sulekha Saxena, Ajay Chaudhary, Shashi Bhusan, Girish Chandra

Department of Anaesthesia, KG’s MU, Lucknow, India..

DOI: 10.4236/ojanes.2013.33045                

Abstract

Objective: To compare the effect of intraperitoneal ropivacaine with placebo for post-operative pain management in patients undergoing laparoscopic cholecystectomy. Material and Methods: All patients were pre-medicated with glycopyrrolate 0.2 mg, ondansetron 4 mg and ranitidine 150 mg intravenously half an hour prior to induction of anesthesia. All patients were given standard general anaesthesia with propofol (2-2.5 mg/kg), fentanyl 2 μg/kg, and succinylcholine (2 mg/kg) to facilitate tracheal intubation. Anesthesia was maintained with 60% N₂O in oxygen with 0.5% to 1% Halothane. Group A: Patients received 20 ml of 0.9% normal saline as placebo (n = 25). Group B: Patients received 20 ml of 0.5% ropivacaine (n = 25). Results: The age and sex distribution of both the groups was similar. The heart rate, systolic & diastolic blood pressure, mean blood pressure and mean trend of SpO₂ in both groups remained similar over the periods. The mean VAS varied considerably within (between time) and between the groups (treatment) and was especially comparatively higher in Group A at initial hours 15 min to 30 min and at end hours 12-24 hrs as compared with Group B. On an average, the frequent dosing of rescue analgesia and mean No. of rescue analgesia doses were higher in Group A followed by Group B. In both groups, the treatment related adverse events were mostly emetic symptoms and shoulder pain with the highest being in Group A. Conclusion: We conclude that intraperitoneal instillation of local anaesthetic is an easy, cheap, and non-invasive method which provides good analgesia in the immediate postoperative period after laparoscopic surgery.

Keywords

Intraperitoneal; Bupivacaine; Cholecystectomy; Anaesthetic

Conflicts of Interest

The authors declare no conflicts of interest.

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