COMPARISON OF INTRAPERITONEAL AND PERIPORTAL 0.5% LEVOBUPIVACAINE AND NORMAL SALINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY

Dr.ASHISH MATHUR; Dr. KUSHAL JETHANI

Volume : VIII, Issue : V, May - 2019

COMPARISON OF INTRAPERITONEAL AND PERIPORTAL 0.5% LEVOBUPIVACAINE AND NORMAL SALINE FOR POSTOPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY

Dr. Ashish Mathur, Dr. Kushal Jethani

Abstract :

AIMS AND OBJECTIVES: To evaluate and compare the efficacy of intraperitoneal and periportal 0.5% Levobupivacaine and normal saline for postoperative pain relief in laparoscopic cholecystectomy. MATERIAL AND METHOD: 60 patients ASA grade I & II undergoing elective cholecystectomy . Patients were classified randomly into 2 groups (thirty patients in each group). Group P ( n=30): 30 ml of normal saline ,Group L ( n=30): 30 ml of 0.5% Levobupivacaine hydrochlori .Randomization was done with the closed envelope technique. A 20 ml of test solution was instillated , by the operating surgeon, on the upper surface of liver and on right sub-diaphragmatic space, under the vision of camera, through the epigastric port with the help of 18 G Spinal needle. Patient was kept in Trendelenberg position for 5 minutes. At the end of procedure, intra-abdominal CO2 was carefully vented out by the surgeon and 10 ml of the test solution was injected as skin infiltrate into all sites of incision post operatively , patients were assessed for parietal pain and visceral pain using a 100 mm VAS scale at 30 min and at 1, 2, 3, 4, 6,12 and 24 hours. Rescue analgesia consisted of an inj. Tramadol 100 mg intravenous (slow) if the VAS score was more than 50. RESULT: Analysis revealed that there were no significant differences between the patients with respect to age, sex, weight, duration of surgery, HR and blood pressure . Duration of postoperative analgesia observed from the time of reversal to first demand of analgesia in the recovery room was more in group L compared to group P. The total analgesic consumption in 24 hours postoperatively, was more in placebo group than in Levobupivacaine group. CONCLUSION: There was significant prolongation of duration of postoperative analgesia in Levobupivacine group as compared to placebo group. In terms of analgesic efficacy, Levobupivacaine appears to be superior to placebo . .