A COMPARATIVE STUDY OF POSTOPERATIVE ANALGESIA FROM INTRAPERITONEAL INSTILLATION OF ROPIVACAINE V/S ROPIVACAINE + FENTANYL IN LAPAROSCOPIC CHOLECYSTECTOMY SURGERIES

Abstract

Background and Aim: This study is designed and conducted to compare the efcacy of intra-peritoneal instillation of ropivacaine to that of a combination of ropivacaine and fentanyl in reducing post-operative pain and the side effects of the same. Aim: To compare the effects of intra-peritoneal instillation of ropivacaine to a combination of ropivacaine and fentanyl on postoperative morbidity in terms of: 1. Post-operative pain 2. Post-operative adverse effects Methods and Material: After approval of the Institutional Ethics Committee (IEC) [IEC/HMPCMCE/105/Faculty/12/107/19] and the Clinical Trials Registry of India [CTRI/2020/04/024616], consenting patients were randomized into two groups of 26 participants each. One group was given intraperitoneal instillation with 15ml of ropivacaine 0.75% diluted in normal saline to make a solution of 45ml and other group was given 15ml of 0.75% ropivacaine with fentanyl 50mcg(1ml) diluted in normal saline to make a solution of 45ml, intra-operatively, and post-operative pain perception and occurrence of adverse effects was recorded. Statistical Analysis: Two sample t-test with equal variances, chi-square test and Fisher's exact test. P value<0.05 was considered signicant Results: Group receiving intraperitoneal instillation of plain ropivacaine was found to have signicantly higher VAS scores and VRS scores (p<0.001) and lesser mean time to requirement of rst-dose of analgesic post-operatively (p<0.001), and lesser incidence of bradycardia (p=0.01) Conclusion: Intraperitoneal instillation of combination of ropivacaine and fentanyl is superior to ropivacaine alone for reducing post-operative pain in patients undergoing laparoscopic cholecystectomy surgery.