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Evaluating the Efficacy of Pre-incisional Infiltration and Intraperitoneal Instillation of a Local Anesthetic Agent on Postoperative Analgesia and Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia

Aim The study aimed to compare the effects of 0.5% bupivacaine injection at pre-incisional port sites and intraperitoneal application on postoperative pain in laparoscopic cholecystectomy cases. Methods After taking ethical clearance, a total of 60 patients of the American Society of Anaesthesia (AS...

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Autores principales: Mishra, Prashant K, Mani, Shreya, Singh, Rakesh Bahadur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8990211/
https://www.ncbi.nlm.nih.gov/pubmed/35415034
http://dx.doi.org/10.7759/cureus.22977
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author Mishra, Prashant K
Mani, Shreya
Singh, Rakesh Bahadur
author_facet Mishra, Prashant K
Mani, Shreya
Singh, Rakesh Bahadur
author_sort Mishra, Prashant K
collection PubMed
description Aim The study aimed to compare the effects of 0.5% bupivacaine injection at pre-incisional port sites and intraperitoneal application on postoperative pain in laparoscopic cholecystectomy cases. Methods After taking ethical clearance, a total of 60 patients of the American Society of Anaesthesia (ASA) grades 1 and 2 scheduled to undergo laparoscopic cholecystectomy were enrolled in the study and were randomized into two groups. Group 1 (n=30) received 20 ml of 0.5% bupivacaine infiltration subcutaneously over the port sites before being given incision. Group 2 (n=30) received 20 ml of 0.5% bupivacaine applied in the intraperitoneal subdiaphragmatic space and in the gall bladder fossa after removal of the gall bladder. The efficacy in terms of abdominal pain, hemodynamics, complications, and total analgesic requirements were assessed at regular intervals throughout the postoperative period for 24 hours. Results No significant difference in terms of demographic variables in the groups. The mean visual analog score (VAS) score for abdominal pain was found to be significantly lower in group 1 from the first postoperative hour till the twenty-fourth hour. Also, no significant difference was seen between the groups regarding hemodynamic parameters. No significant difference between the groups was seen regarding postoperative nausea and vomiting (PONV). The supplemental analgesic requirement was significantly higher in group 2 than in group 1. Conclusion It was observed from this study that pre-incisional infiltration of a local anesthetic agent produces effective postoperative analgesia in the immediate postoperative hours and reduces additional analgesic requirements without causing any adverse reactions.
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spelling pubmed-89902112022-04-11 Evaluating the Efficacy of Pre-incisional Infiltration and Intraperitoneal Instillation of a Local Anesthetic Agent on Postoperative Analgesia and Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia Mishra, Prashant K Mani, Shreya Singh, Rakesh Bahadur Cureus Anesthesiology Aim The study aimed to compare the effects of 0.5% bupivacaine injection at pre-incisional port sites and intraperitoneal application on postoperative pain in laparoscopic cholecystectomy cases. Methods After taking ethical clearance, a total of 60 patients of the American Society of Anaesthesia (ASA) grades 1 and 2 scheduled to undergo laparoscopic cholecystectomy were enrolled in the study and were randomized into two groups. Group 1 (n=30) received 20 ml of 0.5% bupivacaine infiltration subcutaneously over the port sites before being given incision. Group 2 (n=30) received 20 ml of 0.5% bupivacaine applied in the intraperitoneal subdiaphragmatic space and in the gall bladder fossa after removal of the gall bladder. The efficacy in terms of abdominal pain, hemodynamics, complications, and total analgesic requirements were assessed at regular intervals throughout the postoperative period for 24 hours. Results No significant difference in terms of demographic variables in the groups. The mean visual analog score (VAS) score for abdominal pain was found to be significantly lower in group 1 from the first postoperative hour till the twenty-fourth hour. Also, no significant difference was seen between the groups regarding hemodynamic parameters. No significant difference between the groups was seen regarding postoperative nausea and vomiting (PONV). The supplemental analgesic requirement was significantly higher in group 2 than in group 1. Conclusion It was observed from this study that pre-incisional infiltration of a local anesthetic agent produces effective postoperative analgesia in the immediate postoperative hours and reduces additional analgesic requirements without causing any adverse reactions. Cureus 2022-03-08 /pmc/articles/PMC8990211/ /pubmed/35415034 http://dx.doi.org/10.7759/cureus.22977 Text en Copyright © 2022, Mishra et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Anesthesiology
Mishra, Prashant K
Mani, Shreya
Singh, Rakesh Bahadur
Evaluating the Efficacy of Pre-incisional Infiltration and Intraperitoneal Instillation of a Local Anesthetic Agent on Postoperative Analgesia and Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia
title Evaluating the Efficacy of Pre-incisional Infiltration and Intraperitoneal Instillation of a Local Anesthetic Agent on Postoperative Analgesia and Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia
title_full Evaluating the Efficacy of Pre-incisional Infiltration and Intraperitoneal Instillation of a Local Anesthetic Agent on Postoperative Analgesia and Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia
title_fullStr Evaluating the Efficacy of Pre-incisional Infiltration and Intraperitoneal Instillation of a Local Anesthetic Agent on Postoperative Analgesia and Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia
title_full_unstemmed Evaluating the Efficacy of Pre-incisional Infiltration and Intraperitoneal Instillation of a Local Anesthetic Agent on Postoperative Analgesia and Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia
title_short Evaluating the Efficacy of Pre-incisional Infiltration and Intraperitoneal Instillation of a Local Anesthetic Agent on Postoperative Analgesia and Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia
title_sort evaluating the efficacy of pre-incisional infiltration and intraperitoneal instillation of a local anesthetic agent on postoperative analgesia and hemodynamics in patients undergoing laparoscopic cholecystectomy under general anesthesia
topic Anesthesiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8990211/
https://www.ncbi.nlm.nih.gov/pubmed/35415034
http://dx.doi.org/10.7759/cureus.22977
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