What is it about?
Wound Infiltration as an Analgesic after Open Cholecystectomy Surgeries for Post-operative Analgesia
Featured Image
Photo by ashu singh on Unsplash
Why is it important?
Post-operative pain is common after abdominal surgery and is a major cause of patient dissatisfaction in post-operative period. Various drugs like opioids, nonsteroidal anti-inflammatory drugs, dexamethasone has been used to control post-operative pain but efficacy is variable. Wound infiltration is being used nowa-days to provide analgesia in immediate post-operative period. Ropivacaine, a newer longer acting local anesthetic, is used due to its less side effects. Tramadol can be used to as an adjuvant to ropivacaine in wound infiltration. A total of 75 patients, posted for open cholecystectomy, were randomly divided into three groups. Group C – inj. normal saline 22 ml, Group R- 0.375% ropivacaine 20 ml + inj. normal saline 2 ml. Group RT- 0.375% ropivacaine 20 ml + inj. tramadol 2 mg/kg in 2 ml. A total volume of 22 ml was infiltrated. Local wound infiltration was done at time of closure according to study groups.VAS score in post-operative period, time for first rescue analgesic, number of rescue doses in first 24 hrs, PONV and patient satisfaction were noted. There was higher VAS score and early requirement of rescue dose in control group compared to group R and RT (p < 0.001). There was also longer duration of analgesia in group RT compared to group R (p < 0.05). Incidences of PONV were comparable in all three groups. Ropivacaine and ropivacaine-tramodol were effective in wound infiltration for post-operative analgesia but later was preferred due to longer duration of action and better patient satisfaction without increased incidence of PONV.
Perspectives
Post-operative pain is common after abdominal surgery and is a major cause of patient dissatisfaction in post-operative period. Various drugs like opioids, nonsteroidal anti-inflammatory drugs, dexamethasone has been used to control post-operative pain but efficacy is variable. Wound infiltration is being used nowa-days to provide analgesia in immediate post-operative period. Ropivacaine, a newer longer acting local anesthetic, is used due to its less side effects. Tramadol can be used to as an adjuvant to ropivacaine in wound infiltration. A total of 75 patients, posted for open cholecystectomy, were randomly divided into three groups. Group C – inj. normal saline 22 ml, Group R- 0.375% ropivacaine 20 ml + inj. normal saline 2 ml. Group RT- 0.375% ropivacaine 20 ml + inj. tramadol 2 mg/kg in 2 ml. A total volume of 22 ml was infiltrated. Local wound infiltration was done at time of closure according to study groups.VAS score in post-operative period, time for first rescue analgesic, number of rescue doses in first 24 hrs, PONV and patient satisfaction were noted. There was higher VAS score and early requirement of rescue dose in control group compared to group R and RT (p < 0.001). There was also longer duration of analgesia in group RT compared to group R (p < 0.05). Incidences of PONV were comparable in all three groups. Ropivacaine and ropivacaine-tramodol were effective in wound infiltration for post-operative analgesia but later was preferred due to longer duration of action and better patient satisfaction without increased incidence of PONV.
Red Flower Publication Publications
Red Flower Publication Pvt Ltd
Read the Original
This page is a summary of: Comparison between Ropivacaine and Ropivacaine Plus Tramodol in Wound Infiltration as an Analgesic after Open Cholecystectomy Surgeries for Post-operative Analgesia, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6519.21.
You can read the full text:
Contributors
The following have contributed to this page
