engleski

Intraperitoneal analgesia for laparoscopic cholecystectomy

Background and Purpose: Although postoperative pain after laparoscopic cholecystectomy is less than open cholecystectomy, many patients still require strong analgesia postoperatively. Intraperitoneal administration of local anaesthetics alone or in combination with opioids can effectively control postoperative pain. The purpose of this study was to assess the analgesic effect of the intraperitoneal administration of bupivacaine and/or tramadol in patients undergoing laparoscopic cholecystectomy. Patients and Methods: For this study, 144 patients undergoing laparoscopic cholecystectomy were randomized in one of four groups: Group C received 50 ml of saline, Group T received 50 ml of saline containing 100 mg tramadol, Group B received 50 ml of 0.25% bupivacaine while patients allocated to Group TB received 50 ml of 0.25% bupivacaine with 100 mg of tramadol intraperitonealy. Visual analogue scale was recorded (half?) and hours, 1, 2, 4, 6 and 24 hours postoperatively. Incidence of postoperative nausea and vomiting (PONV) was also recorded. In addition, supplementary analgesic and antiemetic consumption were assessed. Results: Pain intensity, PONV as well as postoperative supplementary medications were significantly lower in Group T, Group B and Group TB than in Group C. There were no differences between the three groups receiving tramadol and/or bupivacain in VAS score, incidence of nausea and vomiting and postoperative analgesic and antiemetic consumption. Conclusion: Intreperitoneal instillation of tramadol and/or bupivacaine is an effective method for management of postoperative pain after laparoscopic cholecystectomy. It significantly reduced supplementary postoperative analgesic and antiemetic medication.

Laparoscopic cholecystectomy; Intraperitoneal analgesia; Local anaesthetics; Opioids

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