Sathish Kumar, D (2020) Effect of Irrigation of Gall Bladder Bed and Trocar Sites with Bupivacine in Management of Post Operative Pain in Patients Undergoing Laparoscopic Cholecystectomy in Tertiary Care Centre. Masters thesis, Stanley Medical College, Chennai.
|
Text
220100220sathish_kumar.pdf Download (3MB) | Preview |
Abstract
INTRODUCTION: Laparoscopic cholecystectomy is the gold standard treatment for benign gallbladder disease. It is characterized by a short hospital stay and an quick return to regular activity. Strategies to manage the different intraabdominal surgical pathologies with a laparoscopic approach offer a significant advantage compared with the conventional technique. Laparoscopic cholecystectomy, surgical outcome in terms of reduced pain and convalescence compared to conventional cholecystectomy. However, the postoperative pain is significant. Pain management with multiple analgesic and opioids has been reported with variable success. The pain in the open cholecystectomy is a parietal pain. In laparoscopic cholecystectomy, pain is derived from multiple situations: incision pain (somatic), deep intraabdominal pain (visceral), and shoulder pain (visceral pain due to phrenic nerve irritation). AIMS AND OBJECTIVES: The aim of this study was to evaluate the use of the irrigation of a local anesthetic, such as bupivacaine, at the surgical bed for postoperative pain reduction. MATERIALS AND METHODS: During the period of October 2018 to October 2019,60 patients of age group 15-60 and both sex underwent laparoscopic cholecystectomy who are admitted in the department of General surgery,Government Stanley Medical college and Hospital.After obtaining consent from the patient,randomised into two groups of 30 each,after removal of gallbladder 20ml of normal saline irrigated to control group and 20 ml of 0.25% bupivacaine irrigated to study group.Postoperative pain was calculated from both groups using visual analog scale at 1,2,3,4,6,12,24 hours and compared.Rescue analgesia was given if VAS was more than 5.Rescue analgesia needed for both groups also calculated. RESULTS: Among these patients the mean age in our study was 36.7 years(control) and 41.1 years(study). The number of females in the study was more compared to that of males in both the groups,the duration of surgery in both groups is comparable, control (94.46mins) and study (93.6mins).Postoperative VAS at different intervals(1,2,3,4,6,12,24 hr) was found to be statistically significant in study group.Out of 60 patients,35 patients needed rescue analgesia ,of them 25 were control group and 10 were study group. CONCLUSION: In conclusion, irrigation with bupivacaine in the surgical bed in laparoscopic cholecystectomy will significantly lowers the intensity of postoperative visceral pain, as well as the analgesic consumption in the initial postsurgical hours.Therefore, we can establish this protocol for use in laparoscopic cholecystectomies with the purpose of faster return of the patient to their normal life, and thus, a shorter hospital stay.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711067 |
| Uncontrolled Keywords: | Cholecystectomy, laparoscopic, bupivacaine, intraperitoneal instillation, postoperative pain. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 09 Feb 2021 02:08 |
| Last Modified: | 09 Feb 2021 02:08 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13954 |
Actions (login required)
 |
View Item |
