Publication:

Evaluation of superiority of preemptive analgesia with instillation of 0.5% bupivacaine before rather than after surgery for laparoscopic cholecystectomy

Background The objective of the study was to evaluate the superiority of preemptive analgesia with instillation of 0.5% bupivacaine before rather than after surgery for laparoscopic cholecystectomy.

Methods A prospective, randomized study of 264 patients in whom laparoscopic Cholecystectomy (LC) was conducted in the department of General Surgery at the SSG and Medical College Baroda during a period of 25 months from October 2010 to October 2012. Randomization was done with prepared close enveloped which randomly allocate the patient in either group A or B. Data collected from each patient were: age, sex, ASA score, hospital stay, duration of surgery, no of trocar used, first request for analgesics, vomiting, duration of surgery, intraperitoneal drain was kept or not , length of hospital stay, any other postoperative complication.

Results During the period of 24 months total 264 patients were undergone cholecystectomy. On comparison between Group A and B, data shows that the mean  VAS is less at all assessment (4, 8 & 24 hrs) for Group A as compared to Group B. Mean parietal pain score VAS is less for Group B as compared to Group A at all assessments.

Conclusions Use of bupivacaine in optimal dose in GB bed reduced the visceral pain and use in skin, SC tissue, muscular tissue reduced the parietal pain. Use of bupivacaine before GB removal is much more cost effective than after removal of GB.