Efficacy of Intraperitoneal Bupivacaine Instillation During Laparoscopic Cholecystectomy in Terms of Reduction in Post-Operative Shoulder Tip Pain & Need for Analgesia

Abstract

Pain after laparoscopic cholecystectomy (laparoscopic cholecystectomy e) is usually an acute pain. Objective: To compare frequency of post-operative shoulder tip pain & need for analgesia, with and without intraperitoneal bupivacaine instillation during laparoscopic cholecystectomy. Settings: Department of Surgery, Allied Hospital Faisalabad. Duration: From 14-07-2017 to 14-01-2018. Study Design: Randomized Controlled Trial. Methodology: A total of 190 cases undergoing laparoscopic cholecystectomy were randomly divided into two equal groups. Group A: laparoscopic cholecystectomy using intraperitoneal bupivacaine instillation. Group B: laparoscopic cholecystectomy without using intraperitoneal bupivacaine instillation. After surgery all patients were observed for post-operative pain and analgesic (NSAID or Opioid) requirement at 8 hours. Results: Out of 190 cases, mean age was calculated as 38.22+9.31 years in Group-A & 37.06+9.43 years in Group-B, 33.68% (n=32) in Group-A & 34.74% (n=33) in Group-B were male whereas 66.32% (n=63) in Group-A and 65.26% (n=62) in Group-B were females, comparison of frequency of post-operative pain and need for analgesia in both groups shows that 12.63% (n=12) in Group-A and 43.16% (n=41) in Group-B had postoperative pain and need for analgesia, p value was 0.000 showing a significant difference. Conclusion: Post-operative shoulder tip pain and need for analgesia was found significantly lower with intraperitoneal bupivacaine instillation during laparoscopic cholecystectomy when compared without it.