A STUDY OF EFFECT OF PLACEMENT OF 0.5% BUPIVACAINE SOAKED SURGICEL IN GALLBLADDER BED ON PAIN RELIEF FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY

Dr. Saurabh Purohit; Dr. Pankaj Kumar Saunakiya

Volume : VIII, Issue : V, May - 2019

A STUDY OF EFFECT OF PLACEMENT OF 0.5% BUPIVACAINE SOAKED SURGICEL IN GALLBLADDER BED ON PAIN RELIEF FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY

Dr. Saurabh Purohit, Dr. Pankaj Kumar Saunakiya

Abstract :

Pain following cholecystectomy although significantly less with laparoscopic approach still remains prime concern in most patients.The aim of this double blind prospective randomized controlled study was to assess the character of pain after laparoscopic cholecystectomy and its relief following 0.5% Bupivacaine soaked surgicel placement on to the gallbladder bed, compared with port-site infiltration with 0.5% bupivacaine. PATIENTS AND METHODS: Sixty symptomatic patients with uncomplicated gall stone disease of both genders, who underwent laparoscopic cholecystectomy, included in to an institutional ethic committee approved protocol from November 2016 to April 2018 for the proposed study. Patients were divided in to two groups of 30 each: test group A (0.5% Bupivacaine soaked surgicel kept in gall bladder bed) and control group B (infiltration of 0.5% bupivacaine at port-sites after wound closure). The character of pain was noted after laparoscopic cholecystectomy and its relief was assessed with Visual analog scale (VAS) scoring. RESULTS: Results showed that overall 60% patients felt visceral pain, while 56.70% and 8.33% patients experienced parietal and shoulder pain respectively. After placing the Bupivacaine soaked surgicel in gallbladder bed in test group A patients, the visceral pain was significantly less than control group B and no one experienced shoulder pain. Group B patients felt significantly less parietal pain after port-site infiltration of 0.5% Bupivacaine when compared to group A, however they experienced visceral and shoulder pain more. A significant difference (p <0.001) in the mean VAS score found at 4hrs, 8hrs, and 24 hrs between the two groups. CONCLUSION: From this study, we concluded that the overall incidence of visceral pain was more than parietal pain and 0.5% Bupivacaine soaked surgicel in gall bladder bed alone was effective in controlling both visceral and shoulder pain after laparoscopic cholecystectomy; however port-site infiltration of 0.5% Bupivacaine was effective in relieving parietal pain only..