Cost Effectiveness of Port Site Bupivacaine Injection in Early PostOperative Period After Laparoscopic Cholecystectomy

Muhammad Rehman  Gulzar; Muhammad  Akram; Umer  Farooq; Salman  Azeem; Sonia  Aslam

doi:10.29054/apmc/2018.14

Muhammad Rehman Gulzar Associate Professor of Surgery, Faisalabad Medical University, Faisalabad
Muhammad Akram Associate Professor of Surgery, Faisalabad Medical University, Faisalabad.
Umer Farooq Senior Registrar Surgical Unit-5 DHQ Hospital, Faisalabad
Salman Azeem PGR Surgical Unit-5 DHQ Hospital, Faisalabad
Sonia Aslam PGR Surgical Unit-5 DHQ Hospital, Faisalabad

DOI: https://doi.org/10.29054/apmc/2018.14

Keywords: Laparoscopic cholecystectomy, Port site bupivacaine infiltration, Postoperative abdominal pain, Cost effectiveness

Abstract

Background: Post-operative Cholecystectomy pain is a very important factor affecting administration of analgesics. Cost of management of this pain may have a big burden on public health care system. Objective: To observe the effect of port site bupivacaine injection on reducing the cost of parentral analgesia in early post-operative period after laparoscopic cholecystectomy. Study design: Randomized Control study. Settings: DHQ Teaching hospital Faisalabad. Duration: 27 September, 2017 – 2nd May, 2018. Methodology: A total of 100 cases were included in this study and were admitted through OPD for elective laparoscopic cholecystectomy. They were divided in to two groups. Group A (study group) received 10 mL of 0.25% bupivacaine injection in 4 ports; 7 mL in epigastric and umbilical ports, 3 mL in the other two port sites at the end of surgery. Group B (control Group) received no Local analgesic treatment. Post-operative monitoring and pain assessment was done using Wong Baker FACES pain rating scale. Inj. Toradol (Ketoralac) 30 mg intravenous was given as recue analgesic when pain score exceeded>3. Results: Post-operative pain was reduced as a result of bupivacaine infiltration in Group A as compared to Group B. As a result, expenditure done on analgesics which are quite expensive was reduced. Two Groups were studied as cases and controls based on delivery of port site infiltration of Local analgesia and pain score was observed. There was a remarkable decrease in use of parentral rescue analgesia as a result. Conclusion: Port-site Infiltration of bupivacaine reduces the cost on management of post op pain and saved funds may be used else- where on the treatment of patients.