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PORT SITE INFILTRATION OF LOCAL ANESTHETIC IN REDUCTION LAPAROSCOPIC CHOLECYSTECTOMY

Ali Kadhim Nazir --- Issam Merdan

Basrah Journal of Surgery مجلة البصرة الجراحية
ISSN: 16833589 Year: 2014 Volume: 20 Issue: 2 Pages: 17-22
Publisher: Basrah University جامعة البصرة

Abstract

PORT SITE INFILTRATION OF LOCAL ANESTHETIC IN REDUCTION LAPAROSCOPIC CHOLECYSTECTOMYAli Kadhim Nazir & Issam Merdan*MB,ChB, FICMS General Surgeon, Al-Sadder Teaching Hospital, Basrah, Iraq.Professor of Surgery, Department of Surgery, Basrah College of Medicine, Basrah University, Iraq.Abstract Laparoscopic cholecystectomy has become a standard technique for gallbladder surgery of symptomatic cholelithiasis. However, pain is the dominant complaint after this surgical procedure.This study aimed to evaluate the efficacy of long acting local anesthetic (Bupivacaine), infiltrated at port sites in amelioration of pain following laparoscopic cholecystectomy. Seventy two patients underwent elective laparoscopic cholecystectomy enrolled in this study, patients were divided into treatment and control groups of 36 patients each. Following removal ofthe gallbladder, treatment group received 20 ml of 0.25% Bupivacaine in divided doses at the trocar sites, unlike control group which receive no treatment. The evaluation of postoperative painwas done at fixed time intervals by McGill Pain Questionnaire, and the dosage of narcotic analgesic Tramadol, was also recorded. Mean pain scores at 6 hours postoperatively in treatment group was less than that of the control group (4.5 and 7.6) respectively with (p<0.05). Pain scores at 12 and 24 hours postoperatively didnot differ between the two study groups (p>0.05). The mean total narcotic analgesic dose used during the first 24 hours postoperatively was less in the treatment group compared to the controlgroup (92 mg and 158 mg) respectively with (p<0.05). The localization of pain during the first 24 hours postoperatively was 58% incisional, 36% intra-abdominal, and shoulder tip pain 6%. In conclusion, postoperative infiltration of long lasting local anesthetic (Bupivacaine) into the port sites of laparoscopic cholecystectomy may be desirable. This is simple, inexpensive, and effectivetechnique to minimize early postoperative pain which can be practiced for elective laparoscopic cholecystectomy.

Keywords

PORT SITE INFILTRATION OF LOCAL ANESTHETIC --- REDUCTION LAPAROSCOPIC CHOLECYSTECTOMY