COMPARISON OF INTRA-PERITONEAL BUPIVACAINE AND INTRAVENOUS PARACETAMOL FOR POSTOPERATIVE PAIN RELIEF AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Introduction: Non-steroidal ant iinammatory drugs (NSAIDs) used for postoperative analgesia have signicant side effects, with paracetamol having a different mechanism of action, a better side effect prole, and intravenous (IV) availability. Aim of the study was to Aims And Objectives: compare intra-peritoneal bupivacaine to intravenous paracetamol for postoperative analgesia after laparoscopic cholecystectomy. Materials And Methods: It is a prospective randomized clinical trial. After ethics committee approval and written informed consent. This study was undertaken in the Government General Hospital, afliated to Siddhartha Medical College ,Vijayawada, Andhra Pradesh. The study included 60 patients with American Society of Anesthesiologists physical status I and II who were scheduled for laparoscopic cholecystectomy. Group I patients were given 2 mg/kg of 0.5% bupivacaine as a local intra-peritoneal application, Group II patients were given IV 1 g paracetamol every 6 hours. Postoperative pain was assessed using the Visual Analog Scale (VAS), Visual Rating Prince Henry Scale (VRS), and shoulder pain. The total number of patients who required rescue analgesia, as well as any side effects, were recorded. The data was analysed using the Students unpaired t-test. P<0.05 was considered statistically signicant. At the 8th, 12th, and 24th postoperativ Results: e hours, the VAS scores in Group I were signicantly higher than in Group II (p=0.001). Although VRS in Group I was higher than VRS in Group II at the 12th and 24th postoperative hours, the difference was statistically signicant only at the 24th postoperative hour 1.53±0.50 vs 1.23±0.43 (p=0.016). Up to 8 hours postoperatively, none of the patients in either group experienced shoulder pain. The total number of patients requiring analgesics was higher in Group II than in Group I. Altho Conclusion: ugh local anaesthetic inltration and intra-peritoneal administration of 0.5% bupivacaine reduce the severity of incisional, visceral, and shoulder pain in the early postoperative period, IV paracetamol provides long-term pain relief after elective laparoscopic cholecystectomy for 24 hours