Comparison Between Analgesic Effects of Pre-Operative and Post-Operative Trocar Site Infiltration of Injection Bupivacaine in Elective Laparoscopic Cholecystectomy

Abstract

Objective: To compare the analgesic efficacy of Local Anaesthetic infiltration with Bupivacaine at Trocar site in Laporoscopic Cholecystectomy when injected preoperatively vs postoperatively. Study Design: Quasi-experimental study. Place and Duration of Study: Department of General surgery, Combined Military Hospital, Rawalpindi Pakistan, from May to Nov, 2016. Patients and Methodology: Patients meeting the inclusion criteria were randomly divided into two groups using coin method. Group A received pre-operative injection of Bupivacaine infiltrated at the trocar sites. Patients in Group B received the similar dosage post-operatively. The pain of the patients was assessed post-operatively using Visual Analog Score (VAS) at 6, 12 and 24 hours and compared. Results: A total of 190 patients were equally divided into Group A and B (95 each). The mean age was 46±13.77 years in Group A and 43±14.80 years in Group B.23.68% (n=45) of patients were aged between 12-24 years, 13.15% (n=25) were of 25-36 years, 22.63% (n=43) were aged 37-48 years and 40.52% (n=77) of the patients were between the age of 49-60 years. 75.78% (n=144) of patients were males, while 24.21% (n=46) were females. The Mean±SD VAS post-operative pain scoring Group A and Group B was 4.5±0.04 vs 5.0± 0.40, respectively. The p-value was <0.001and the difference is statically significant. Conclusion: We concluded that the use of pre-operative local anesthesia helps reduce post-operative pain in patients undergoing laparoscopic cholecystectomy.