Postoperative pain relief after laparoscopic cholecystectomy: To compare the effectiveness of intraperitoneal ropivacaine vs lidocaine

Neeraj Kumar; Saurabh Suman; Kapil Rastogi; Yashpal Singh; Umesh Kumar Bhadani; Manish Kumar

Volume : VII, Issue : VI, June - 2017

Postoperative pain relief after laparoscopic cholecystectomy: To compare the effectiveness of intraperitoneal ropivacaine vs lidocaine

Neeraj Kumar, Saurabh Suman, Kapil Rastogi, Yashpal Singh, Umesh Kumar Bhadani, Manish Kumar

Abstract :

Introduction: Patients undergoing laparoscopic procedures do experience postoperative pain, especially in the abdomen, back, and shoulder region. Intraperitoneal injections of a local anaesthetic have been proposed to minimize postoperative pain after laparoscopic surgery. Therefore, this prospective, randomized study was conducted to compare the effectiveness of intraperitoneal lidocaine with that of Intraperitoneal Ropivacaine for postoperative analgesia after laparoscopic cholecystectomy (LC) surgery. Material and methods: Institute of Medical Sciences, Banaras Hindu University, Department of Anaesthesiology & Critical care, Varanasi, Uttar Pradesh. Fifty patients with ASA I or II undergoing LC were included in the study. They were classified randomly into two groups: group L which comprised 25 patients who were given 200 mg Lidocaine in 20 ml normal saline intraperitoneally and group R which included 25 patients who were given 0.2% Ropivacaine 20ml intraperitoneally. Postoperative pain was recorded using the visual analogue scale for 24 h after LC. Postoperative analgesic consumption was also recorded. Results: The difference in VAS scores of the two treatment groups at the four times points (0, 4, 8 and 12) in both the treatment groups hours across the 12 hours time period is not significant. The mean visual analogue scale over 24 hours was higher in the ropivacaine group (4.57± 0.48) when compared to lignocaine group (4.18 ± 0.56) but was statistically significant (p<0.05) (P =0.010). The incidence of shoulder pain was 24 % in lidocaine group and 16 % in ropivacaine group. The mean value of total analgesic consumption in the form of intravenous paracetamol was significantly lower in the both lidocaine group (2.3 g ± 0.60) as well as in ropivacaine group (2.5 g ± 0.63) and were statistically not significant. There were no significant differences between the two groups with regards to haemodynamic. Conclusion: Intraperitoneal instillation of ropivacaine or lignocaine is an effective method of postoperative pain relief in laparoscopic cholecystectomy. Both these drugs significantly reduced the postoperative pain.