What is it about?

Nebulization of 0.5% Ropivacaine in Laparoscopic Cholecystectomy for Post-operative Pain Relief

Featured Image

Why is it important?

Objective: The etiology of postoperative pain in patients undergoing laproscopic cholecystectomy is multifactorial consisting of incisional and visceral pain from the operation itself and parietal pain from trauma and irritation to the peritoneum and diaphragm. Design: This randamozied single blind study was conducted on 60 patients of either sex undergoing laproscopic cholecystectomy under general anesthesia. Group A [n=30] received 15 ml of 0.5% ropivacaine by instillation and group B [n=30] received 15 ml of 0.5% ropivacane intraperitoneally by piston type of nebulization 10 minutes before surgery and both the groups got 5 ml [0.5%] ropivacaine at the trocar site at the end of surgery. Results: Patients in both the groups were comparable with respect to age, sex and weight [p>0.05]. VAS score for incisional pain was significantly lower in Group A at 1hour and 8 hrs postoperatively [p=0.02 and p=0.04] respectively. At all other intervals the incisional pain, Visceral pain and shoulder tip pain was comparable amongst the two groups [p>0.05]. Time to first analgesia was longer in group A [2.29 hrs] as compared to Group B [1.66 hrs] but was stastically insignifiacant [p>0.5]. Mean total number of analgesic used was 1.4 in both the groups [p=1]. Conclusion: Intraoperative subdiaphgramatic and intraperitoneal instillation of ropivacaine 0.5% is beneficial and better modality of pain relief because of ease of technique and better VAS scores as compared to intrperitoneal nebulization of ropivacaine.

Perspectives

Objective: The etiology of postoperative pain in patients undergoing laproscopic cholecystectomy is multifactorial consisting of incisional and visceral pain from the operation itself and parietal pain from trauma and irritation to the peritoneum and diaphragm. Design: This randamozied single blind study was conducted on 60 patients of either sex undergoing laproscopic cholecystectomy under general anesthesia. Group A [n=30] received 15 ml of 0.5% ropivacaine by instillation and group B [n=30] received 15 ml of 0.5% ropivacane intraperitoneally by piston type of nebulization 10 minutes before surgery and both the groups got 5 ml [0.5%] ropivacaine at the trocar site at the end of surgery. Results: Patients in both the groups were comparable with respect to age, sex and weight [p>0.05]. VAS score for incisional pain was significantly lower in Group A at 1hour and 8 hrs postoperatively [p=0.02 and p=0.04] respectively. At all other intervals the incisional pain, Visceral pain and shoulder tip pain was comparable amongst the two groups [p>0.05]. Time to first analgesia was longer in group A [2.29 hrs] as compared to Group B [1.66 hrs] but was stastically insignifiacant [p>0.5]. Mean total number of analgesic used was 1.4 in both the groups [p=1]. Conclusion: Intraoperative subdiaphgramatic and intraperitoneal instillation of ropivacaine 0.5% is beneficial and better modality of pain relief because of ease of technique and better VAS scores as compared to intrperitoneal nebulization of ropivacaine.

Red Flower Publication Publications
Red Flower Publication Pvt Ltd

Read the Original

This page is a summary of: Comparison of Preemptive Intraperitoneal Instillation and Nebulisation of 0.5% Ropivacaine in Laparoscopic Cholecystectomy for Post-operative Pain Relief, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6419.54.
You can read the full text:

Read

Contributors

The following have contributed to this page